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General NPI Number Information
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NPI Number | 1386598134
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Entity Type | Organization
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Legal Business Name | GRAYS RIVER HOMECARE, LLC
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 162 N 4032 E
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City | RIGBY
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State | ID
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Zip | 83442-4962
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Country | US
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Telephone | 208-403-5642
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Fax |
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Provider Business Mailing Address
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Address Line | 162 N 4032 E
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City | RIGBY
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State | ID
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Zip | 83442-4962
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Country | US
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Telephone | 208-403-5642
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MIRANDA HILLMAN
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Credential |
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Telephone | 208-403-5642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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