MEDICARE: AUBURN CREST HOSPICE, 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1811170236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUBURN CREST HOSPICE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1176
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83680-1176
Country	:	US
Telephone Number	:	208-376-7298
Fax Number	:	208-377-8310

Provider Business Practice Location Address
First Line	:	8382 N WAYNE DR STE 205
Second Line	:
City	:	HAYDEN
State	:	ID
Zip	:	83835-6028
Country	:	US
Telephone Number	:	208-665-8111
Fax Number	:	208-665-8112

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JASON FLETCHER
Credential	:
Telephone Number	:	208-376-7298

Provider Enumeration Date	:	12/07/2007
Last Update Date	:	08/09/2024

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