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General NPI Number Information
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NPI Number | 1194687236
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Entity Type | Organization
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Legal Business Name | CALDWELL SENIOR LIVING LLC
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Dates
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Enumeration Date | 11/26/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 4119 LENITY LIVING AVE
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City | CALDWELL
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State | ID
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Zip | 83605-4988
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Country | US
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Telephone | 208-454-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 4119 LENITY LIVING AVE
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City | CALDWELL
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State | ID
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Zip | 83605-4988
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR LEGAL/RISK MANAGER
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Name | ALICIA CEPEDA
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Credential |
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Telephone | 385-342-5175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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