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General NPI Number Information
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NPI Number | 1407019482
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Entity Type | Organization
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Legal Business Name | ADDUS HEALTHCARE (IDAHO), INC.
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 415 W 9TH ST
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City | LIBBY
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State | MT
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Zip | 59923-1766
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Country | US
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Telephone | 406-293-9651
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Fax | 406-293-9706
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Provider Business Mailing Address
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Address Line | 801 WARRENVILLE RD STE 800
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City | LISLE
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State | IL
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Zip | 60532-0912
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Country | US
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Telephone | 630-296-3400
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Fax | 630-487-2713
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Authorized Official
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Title or Position | EVP, CHIEF STRATEGY OFFICER
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Name | DARBY ANDERSON
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Credential |
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Telephone | 630-296-3443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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