Healthcare Provider Details
I. General information
NPI: 1063064871
Provider Name (Legal Business Name): A-1 HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2019
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6700 W OVERLAND RD
BOISE ID
83709
US
IV. Provider business mailing address
6700 W OVERLAND RD
BOISE ID
83709
US
V. Phone/Fax
- Phone: 208-377-3113
- Fax: 208-377-8338
- Phone: 208-377-3113
- Fax: 208-377-8338
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372500000X |
| Taxonomy | Chore Provider |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
TAMMIE
M
CASTEEL
Title or Position: CEO/OWNER
Credential:
Phone: 208-377-3113