Healthcare Provider Details

I. General information

NPI: 1457802860
Provider Name (Legal Business Name): AHC HOME HEALTH OF COEUR D ALENE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 NORTHWEST BLVD STE 103
COEUR D ALENE ID
83814-5605
US

IV. Provider business mailing address

1450 NORTHWEST BLVD STE 103
COEUR D ALENE ID
83814-5605
US

V. Phone/Fax

Practice location:
  • Phone: 208-769-0500
  • Fax: 208-769-0515
Mailing address:
  • Phone: 208-769-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: FOREST ARNETT
Title or Position: PRESIDENT
Credential:
Phone: 385-622-4500