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General NPI Number Information
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NPI Number | 1760041263
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Entity Type | Organization
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Legal Business Name | IN HOME CARE FOR YOU LLC
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Dates
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Enumeration Date | 06/08/2019
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Last Update Date | 06/08/2019
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Provider Practice Location Address
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Address Line | 609 MAIN STREET
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City | DEARY
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State | ID
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Zip | 83823
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Country | US
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Telephone | 208-596-7272
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 92
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City | DEARY
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State | ID
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Zip | 83823
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Country | US
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Telephone | 883-509-4663
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Fax |
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Authorized Official
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Title or Position | OWNER/ MANAGING MEMBER
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Name | JOLEEN MICHELLIE TIETZ
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Credential |
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Telephone | 208-596-7272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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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 | 251B00000X
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Taxonomy Name | Case Management 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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training 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 | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #10
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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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