Healthcare Provider Details

I. General information

NPI: 1750202909
Provider Name (Legal Business Name): CASCADIA HOSPICE OF IDAHO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 E RIVERSIDE DR STE 100
EAGLE ID
83616-7621
US

IV. Provider business mailing address

2205 E RIVERSIDE DR STE 100
EAGLE ID
83616-7621
US

V. Phone/Fax

Practice location:
  • Phone: 208-994-6321
  • Fax: 208-918-3303
Mailing address:
  • Phone: 208-994-6321
  • Fax: 208-918-3303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LAURA RITTER
Title or Position: VP OF OPERATIONS
Credential:
Phone: 303-803-5149