Healthcare Provider Details

I. General information

NPI: 1598691586
Provider Name (Legal Business Name): JESSE GURR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 S CLEARWATER LOOP STE R
POST FALLS ID
83854-9599
US

IV. Provider business mailing address

784 S CLEARWATER LOOP STE R
POST FALLS ID
83854-9599
US

V. Phone/Fax

Practice location:
  • Phone: 986-275-7730
  • Fax:
Mailing address:
  • Phone: 986-275-7730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateID
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: