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General NPI Number Information
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NPI Number | 1457858052
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Entity Type | Organization
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Legal Business Name | ADVANCED HOME HEALTH AND HOSPICE
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 09/29/2020
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Provider Practice Location Address
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Address Line | 444 HOSPITAL WAY STE 223
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City | POCATELLO
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State | ID
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Zip | 83201-2742
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Country | US
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Telephone | 208-269-1200
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Fax | 208-269-1220
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Provider Business Mailing Address
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Address Line | PO BOX 1784
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City | IDAHO FALLS
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State | ID
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Zip | 83403-1784
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Country | US
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Telephone | 208-346-7807
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Fax | 208-346-7790
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHERYL ABEL
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Credential |
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Telephone | 208-346-7807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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