Healthcare Provider Details

I. General information

NPI: 1700908274
Provider Name (Legal Business Name): AT HOME HEALTH CARE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 N 100 W
SALINA UT
84654-1363
US

IV. Provider business mailing address

45 N 100 W
SALINA UT
84654-1116
US

V. Phone/Fax

Practice location:
  • Phone: 435-529-3233
  • Fax: 435-529-3444
Mailing address:
  • Phone: 435-529-3233
  • Fax: 435-529-3444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2014-HHA-846
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number2012-HOSPICE-49553
License Number StateUT

VIII. Authorized Official

Name: MRS. VICKI GURNEY
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 435-529-3233