NPI age
5 years
Enumerated 2020-06-02
● Active Type 2 · Organization
Grace Memory Care At State Street Llc
Grace Memory Care At State Street Llc is 1 of 201 assisted living facility organizations in Idaho.
Primary specialty
Assisted Living Facility
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Hines
Owner
Last NPPES update
2020-06-02
Source: monthly bulk 2026-05
How this organization compares
Across 201 active assisted living facility providers in Idaho.
NPI age
5 years
≈ at median (5 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2020 → 2026
2020-06Enumerated in NPPES
2020
2026
Where they practice
Primary practice location
9779 W State St
Boise, ID 837141638
Mailing address
890 N Cole Rd
Boise, ID 837048638
Authorized official
Linda Hines
Owner
📞 2088533337
Specialties
-
Assisted Living Facility PrimaryA 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.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | A0003650 |
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.