Grace at Fairview Lakes LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GRACE AT FAIRVIEW LAKES LLC

Practice address

1960 N Lakes PL
Meridian, ID 83646-5939

Phone

(208) 844-8080

NPI assigned

Jun 2, 2020

Organization subpart

No

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) 867-1001

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1790309045",
    "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": "208-884-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 N LAKES PL",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465939",
            "telephone_number": "208-844-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE AT FAIRVIEW LAKES 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": "208-867-1001"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M8073365",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Meridian, ID
• Providers in Meridian, ID by specialty
• Assisted Living Facility in Idaho

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.