Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Edgewood Plantation Place LLC

Assisted Living Facility in Boise, ID · enumerated 2011 · authorized official John Dybwad, Vp of Finance.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1023305497

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Registry record

Entity type Organization (Type 2)

Legal business name Edgewood Plantation Place LLC

Practice address 3921 Kessinger Ln, Boise, ID, 83703

Phone (208) 853-7300

Fax (208) 853-9328

Enumeration date Jul 6, 2011

Last updated in NPPES Aug 18, 2022

Taxonomy & classification

310400000X Assisted Living Facility Nursing & Custodial Care Facilities · License 83703 (ID) Primary

Authorized official

Name John Dybwad

Title Vp of Finance

Phone (701) 757-5422

Other identifiers

Identifier	Type	State	Issuer
A0000774	Medicaid	ID	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2022-08-18. Verify at npiregistry.cms.hhs.gov.

Where is Edgewood Plantation Place LLC located?

The practice location on file with NPPES is in Boise, ID.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-08-18.