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13D2193839 CLIA NUMBER - WELLSPRING MEADOWS ASSISTED LIVING

Laboratory Demographics

CLIA Number: 13D2193839

Facility Name: WELLSPRING MEADOWS ASSISTED LIVING

Facility Address:
9873 N BUTTERCUP LANE
HAYDEN, ID
ZIP 83835
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Facility Phone Number: 208 762-9001

Facility Type: Assisted Living Facility

Certificate Type: Waiver
NPI Number: 1497371264

Taxonomy: 3747P1801X - Technician
An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards

CLIA Record

Field Name Field Value
CLIA Number 13D2193839
LAB Type Assisted Living Facility
Facility Name WELLSPRING MEADOWS ASSISTED LIVING
Street 9873 N BUTTERCUP LANE
City HAYDEN
State ID
ZIP 83835
Phone 208 762-9001
CertificateType 4
CertificateEffectiveDate 9/25/2022
CertificateExpirationDate 9/24/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024