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General NPI Number Information
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NPI Number | 1134039753
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Entity Type | Organization
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Legal Business Name | GARDEN CITY SENIOR LIVING
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Dates
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Enumeration Date | 09/08/2026
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Last Update Date | 09/08/2026
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Provider Practice Location Address
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Address Line | 8250 W MARIGOLD ST
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City | GARDEN CITY
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State | ID
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Zip | 83714-1354
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Country | US
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Telephone | 208-740-6551
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1176
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City | MERIDIAN
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State | ID
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Zip | 83680-1176
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Country | US
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Telephone | 208-376-7298
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Fax | 208-377-8310
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Authorized Official
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Title or Position | MEMBER
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Name | KAMERON LEMON
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Credential | MEMBER
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Telephone | 208-250-5875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number |
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License Number State |
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