Healthcare Provider Details

I. General information

NPI: 1699397166
Provider Name (Legal Business Name): AT HOME WITH THE WESTERNHOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 05/07/2020
Certification Date: 05/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5307 CARAWAY LN
CEDAR FALLS IA
50613-8172
US

IV. Provider business mailing address

5307 CARAWAY LN
CEDAR FALLS IA
50613-8172
US

V. Phone/Fax

Practice location:
  • Phone: 319-277-7779
  • Fax:
Mailing address:
  • Phone: 319-277-7779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BRIANA HILMER
Title or Position: SENIOR DIRECTOR
Credential: RN
Phone: 319-277-7779