Healthcare Provider Details

I. General information

NPI: 1558369256
Provider Name (Legal Business Name): IDAHO HOME HEALTH & HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 EASTLAND DR
TWIN FALLS ID
83301-6858
US

IV. Provider business mailing address

826 EASTLAND DR
TWIN FALLS ID
83301-6858
US

V. Phone/Fax

Practice location:
  • Phone: 208-734-4061
  • Fax: 208-733-5980
Mailing address:
  • Phone: 208-734-4061
  • Fax: 208-733-5980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHH/142
License Number StateID

VIII. Authorized Official

Name: MS. DEBBIE OSBORN
Title or Position: CONTROLLER/ADMINISTRATOR
Credential:
Phone: 208-734-4061