Healthcare Provider Details

I. General information

NPI: 1982421525
Provider Name (Legal Business Name): FREE AIR LIFE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 07/11/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 E SHERMAN AVE STE 209
COEUR D ALENE ID
83814-5362
US

IV. Provider business mailing address

PO BOX 6
DINUBA CA
93618-0006
US

V. Phone/Fax

Practice location:
  • Phone: 855-286-0241
  • Fax:
Mailing address:
  • Phone: 559-681-3287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: CARRIE ANNE HOGUE
Title or Position: EXECUTIVE DIRECTOR / OWNER
Credential:
Phone: 559-681-3287