Organization Active NPI

Grace at Englefield Green LLC

  • Assisted Living Facility
  • Boise, ID
National Provider Identifier
1447874797
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GRACE AT ENGLEFIELD GREEN LLC
Practice address
250 S Allumbaugh Way
Boise, ID 83709-5624
Phone
(208) 322-8080
NPI assigned
Jun 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Linda Hines
Title
Owner
Phone
(208) 322-8080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

250 S Allumbaugh Way
Boise, ID 83709-5624

Mailing address

890 N Cole Rd
Boise, ID 83704-8638
Phone (208) 322-8080

Other identifiers 1

IdentifierTypeStateIssuer
A0000106MedicaidID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2194044Grace at Englefield Green LLC250 S Allumbaugh Way, Boise, ID 83709Certificate of waiverSep 27, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591056000000",
    "number": "1447874797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048638",
            "telephone_number": "208-322-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S ALLUMBAUGH WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837095624",
            "telephone_number": "208-322-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE AT ENGLEFIELD GREEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-322-8080"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A0000106",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.