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General NPI Number Information
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NPI Number | 1700167400
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Entity Type | Organization
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Legal Business Name | EH HOME HEALTH OF THE WEST, LLC
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Dates
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Enumeration Date | 09/08/2011
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 3686 WASHINGTON PKWY
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7573
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Country | US
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Telephone | 208-528-8100
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Fax | 208-528-5232
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Provider Business Mailing Address
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Address Line | 6688 N CENTRAL EXPY SUITE 1300
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City | DALLAS
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State | TX
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Zip | 75206-3950
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Country | US
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Telephone | 214-239-6500
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Fax | 214-239-6581
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Authorized Official
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Title or Position | EVP OF HOME HEALTH OPERATIONS
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Name | JULIE DIANE JOLLEY
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Credential |
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Telephone | 214-239-6500
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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 | HH221
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License Number State | ID
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