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General NPI Number Information
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NPI Number | 1912917329
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Entity Type | Organization
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Legal Business Name | ADVANCED HOME HEALTH INCORPORATED
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1015 W IRONWOOD DR SUITE 100
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4952
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Country | US
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Telephone | 208-765-2140
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Fax | 208-665-5559
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Provider Business Mailing Address
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Address Line | 1015 W IRONWOOD DR SUITE 100
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4952
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Country | US
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Telephone | 208-765-2140
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Fax | 208-665-5559
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SUSAN LYNN ECONOMON
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Credential | R.N.
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Telephone | 208-665-5579
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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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