Grace At Fairview Lakes Llc

Specialty details in registry · Meridian, ID

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At a glance

1960 N Lakes Pl, Meridian, ID 83646-5939

NPPES record updated Jun 2, 2020. Public records can lag behind changes at a practice.

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Practice location

1960 N Lakes Pl
Meridian, ID 83646-5939

Professional details: NPI, taxonomy & registry record

NPI1790309045

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 310400000X
Enumeration date: Jun 2, 2020
Record updated: Jun 2, 2020

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

310400000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1960 N Lakes Pl
Meridian, ID 83646-5939

Phone: (208) 844-8080

Mailing address

890 N COLE RD

BOISE, ID 837048638

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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