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General NPI Number Information
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NPI Number | 1942023213
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Entity Type | Organization
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Legal Business Name | FOUNTAIN HILLS MEDICAL & HOME HOME HEALTH AGENCY LLC
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 1705 11TH ST
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City | LEWISTON
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State | ID
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Zip | 83501-3932
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Country | US
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Telephone | 208-553-4308
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Fax |
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Provider Business Mailing Address
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Address Line | 1705 11TH ST
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City | LEWISTON
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State | ID
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Zip | 83501-3932
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Country | US
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Telephone | 208-553-4308
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEMBI JUDIS CHE
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Credential | DNP, ARNP
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Telephone | 509-780-3155
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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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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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