1528225729 NPI number — ADVANCED HOME HEALTH & STAFFING INC.

Table of content: (NPI 1528225729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528225729 NPI number — ADVANCED HOME HEALTH & STAFFING INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED HOME HEALTH & STAFFING INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528225729
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
321 2ND STREET SO.
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
NAMPA
Provider Business Mailing Address State Name:
IDAHO
Provider Business Mailing Address Postal Code:
83651
Provider Business Mailing Address Country Code:
UM
Provider Business Mailing Address Telephone Number:
208-468-0140
Provider Business Mailing Address Fax Number:
208-466-0580

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8030 W EMERALD ST
Provider Second Line Business Practice Location Address:
SUITE 185
Provider Business Practice Location Address City Name:
BOISE
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83704-9060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-321-7896
Provider Business Practice Location Address Fax Number:
208-321-8065
Provider Enumeration Date:
05/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DAHM
Authorized Official First Name:
RHONDA
Authorized Official Middle Name:
Authorized Official Title or Position:
REGIONAL DIRECTOR
Authorized Official Telephone Number:
208-468-0140

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 806183300 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".




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