Grace At State Street Llc

LBN: Grace At State Street Llc
Grace At State Street Llc is an health care organization with primary practice located at 9995 W State St , Boise ID 83714-1636. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Grace At State Street Llc can be contacted via phone (208) 853-3337, or through Hines, Linda via phone (208) 342-1312.

Contact Information

Primary practice address
9995 W State St Boise ID 83714-1636
Phone: (208) 853-3337
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Hines, Linda
Phone: (208) 342-1312

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X

Profile Details

NPI number 1356965693
LBN Legal business name Grace At State Street Llc
DBA Doing business as
Authorized official Hines, Linda
Entity Organization
Organization subpart 1 No
Enumeration date Jun 2nd, 2020
Last updated Jun 2nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356965693 NPPES
Idaho MEDICAID A0002183

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