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General NPI Number Information
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NPI Number | 1811840556
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Entity Type | Organization
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Legal Business Name | BEEWELL ASSISTED LIVING WINTERBERRY LLC
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Dates
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Enumeration Date | 02/20/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 3989 E WINTERBERRY DR
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City | NAMPA
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State | ID
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Zip | 83687-7517
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Country | US
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Telephone | 208-461-7822
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Fax |
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Provider Business Mailing Address
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Address Line | 500 WESTOVER DR # 32241
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City | SANFORD
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State | NC
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Zip | 27330-8941
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Country | US
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Telephone | 801-987-0567
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. BRANDON SCOTT GUSTAFSON
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Credential | MBA, MHA
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Telephone | 801-987-0567
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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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