NPI 1407502297
Table Rock Senior Living LLC
Practice location
- Address
- 1675 E Riverside Dr STE 150, Eagle, ID 83616-7584
- Phone
- (208) 401-1400
Authorised official
- Name
- Amber L Tueller
- Title
- Secretary
- Phone
- (208) 207-2726
Registered specialties
Assisted Living Facility
Primary
Registry record
- NPI
- 1407502297
- Entity type
- Organization
- NPI issued
- 1 Mar 2022
- Record last updated
- 11 Jun 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.