Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edgewood Plantation Place LLC

Organization Assisted Living Facility · NPI 1023305497

Edgewood Plantation Place LLC is an Assisted Living Facility in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2011.

Licensed in
ID
In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3921 Kessinger Ln
Boise, ID 83703-3003
Phone: (208) 853-7300
Fax: (208) 853-9328
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence 83703 (ID)

Record details

NPI number1023305497
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Dybwad — Vp Of Finance · (701) 757-5422
NPI enumeratedJuly 6, 2011
Last updated in NPPESAugust 18, 2022
Certification dateAugust 18, 2022
Mailing addressPo Box 13238, Grand Forks, ND 58208

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