GRACE MEMORY CARE AT STATE STREET LLC


Address: 9779 W State St, Boise, ID 83714-1638
Phone: 2088533337

GRACE MEMORY CARE AT STATE STREET LLC (NPI# 1164046413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164046413
Entity Type Organization
Organization Name GRACE MEMORY CARE AT STATE STREET LLC
Practice Address 9779 W State St
Boise
ID 83714-1638
Mailing Address 890 N Cole Rd
Boise
ID 83704-8638
Practice Telephone 2088533337
Mailing Telephone 2088533337
Enumeration Date 2020-06-02
Last Update Date 2020-06-02
Authorized Official Name LINDA HINES (OWNER)
Authorized Official Telephone 2088533337
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 310400000X Assisted Living Facility Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
ID A0003650 05

Office Location

Street Address 9779 W STATE ST
City BOISE
State ID
Zip Code 83714-1638

Providers in the same zip code

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1841646007 Alliance Medical Group, LLC Family Medicine 5601 W. Chinden Blvd., Garden City, ID 83714 2016-05-06
1134580467 Rebecca Gillet Physical Therapist 6576 W Dufferin Ct, Boise, ID 83714 2016-03-15
1063816007 Ingri Suzanne Koloski Counselor 8969 West Hepburn Lane, Garden City, ID 83714 2014-10-20
1679909329 Anile Nina Counselor 5484 N Gary Lane, Boise, ID 83714 2013-09-25
1215360292 William Blake Bybee Dentist 5833 W. Hidden Springs Dr., Boise, ID 83714 2013-08-14
1871833327 Charmaine Read Social Worker 123 E. 44th St, Ste. A, Garden City, ID 83714 2013-02-20
1811206576 Bennett Medical Services Durable Medical Equipment & Medical Supplies 5220 Sawyer Court, Suite D, Garden City, ID 83714 2010-09-29
1073780680 Barry Lynn Williams Pharmacist 7020 W State Street, Boise, ID 83714 2008-05-13
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Taxonomy Information

Taxonomy Code 310400000X
Grouping Nursing & Custodial Care Facilities
Classification Assisted Living Facility

Taxonomy Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619593068 Frontier Management, LLC Assisted Living Facility 10250 W Smoke Ranch Dr, Boise, ID 83709-1467 2020-06-22
1356965693 Grace At State Street LLC Assisted Living Facility 9995 W State St, Boise, ID 83714-1636 2020-06-02
1447874797 Grace At Englefield Green LLC Assisted Living Facility 250 S Allumbaugh Way, Boise, ID 83709-5624 2020-06-02
1942848502 The Spaulding Home LLC Assisted Living Facility 1709 W Spaulding St, Boise, ID 83705-4223 2019-12-13
1023671435 Edgewood Castle Hills LLC Assisted Living Facility 5955 W Castle Dr, Boise, ID 83703-3215 2019-04-22
1477016012 Veranda At Barber Station LLC Assisted Living Facility 3266 E. Barber Valley Drive, Boise, ID 83712 2019-04-10
1114383577 Edgewood Spring Creek Eagle Island LLC Assisted Living Facility 12426 W Explorer Dr Ste 220, Boise, ID 83713-1560 2016-01-14
1568843605 Treasure Valley Senior Living, Inc. Assisted Living Facility 1777 S Curtis Rd, Boise, ID 83705-2708 2015-06-15
1083959902 Brookdale Senior Living Communities, Inc. Assisted Living Facility 739 E Parkcenter Blvd, Boise, ID 83706-6511 2012-12-04
1821366998 Bronco Senior Services Assisted Living Facility 1093 S Hilton St, Boise, ID 83705-1971 2011-12-05
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Competitor

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City BOISE
Zip Code 83714

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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