Healthcare Provider Details

I. General information

NPI: 1669471082
Provider Name (Legal Business Name): HOME HEALTH PROFESSIONALS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 MAIN AVE E
TWIN FALLS ID
83301-6229
US

IV. Provider business mailing address

147 MAIN AVE E
TWIN FALLS ID
83301-6229
US

V. Phone/Fax

Practice location:
  • Phone: 208-733-8600
  • Fax: 208-733-9449
Mailing address:
  • Phone: 208-733-8600
  • Fax: 208-733-9449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHH-211
License Number StateID

VIII. Authorized Official

Name: BARBARA R BACON-PAVLOVIC
Title or Position: COMPTROLLER
Credential:
Phone: 208-733-8600