Organization
GRANDMAS CARE HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL S BECK (SECRETARY TREASURER)
(208) 362-9800
Entity
Organization
Contact information
Practice address
8418 WEST LAJOLLA STREET, BOISE, ID 83709-5194
(208) 362-9800
(208) 362-9802
Mailing address
PO BOX 191037, BOISE, ID 83719-1037
(208) 362-9800
(208) 362-9802
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
RC844
ID
Other
Enumeration date
03/31/2006
Last updated
08/22/2020
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