MEDICARE: ASSURANCE FAMILY CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1235902610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURANCE FAMILY CARE LLC

Provider Business Mailing Address
First Line	:	330 SHOUP AVE STE 204
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83402-3650
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 SHOUP AVE STE 204
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83402-3650
Country	:	US
Telephone Number	:	208-516-2041
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	NATASHA OHENE OPARE
Credential	:
Telephone Number	:	208-497-8611

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	11/07/2023

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