Provider Demographics
NPI:1851544084
Name:BEEHIVE HOMES OF NORTH IDAHO
Entity Type:Organization
Organization Name:BEEHIVE HOMES OF NORTH IDAHO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GHRAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-765-8364
Mailing Address - Street 1:2100 E SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-5335
Mailing Address - Country:US
Mailing Address - Phone:208-765-8364
Mailing Address - Fax:208-765-3396
Practice Address - Street 1:2100 E SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-5335
Practice Address - Country:US
Practice Address - Phone:208-765-8364
Practice Address - Fax:208-765-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRC-762310400000X
IDRC-779310400000X
IDRC-869310400000X
IDRC-934310400000X
IDRC-853310400000X
IDRC-881310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility