MEDICARE: FHL 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1568057479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FHL LLC

Provider Business Mailing Address
First Line	:	22976 MORNINGLIGHT DR
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57703-9039
Country	:	US
Telephone Number	:	605-939-3880
Fax Number	:

Provider Business Practice Location Address
First Line	:	22976 MORNINGLIGHT DR
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57703-9039
Country	:	US
Telephone Number	:	605-431-4778
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NANETH KALLIO
Credential	:
Telephone Number	:	605-939-3880

Provider Enumeration Date	:	03/02/2021
Last Update Date	:	03/02/2021

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Directions to “FHL LLC ” Practice Location

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