1831135474 NPI number — CARE AT HOME, INC.

Table of content: (NPI 1831135474)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831135474 NPI number — CARE AT HOME, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE AT HOME, 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:
6
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:
1831135474
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
746 E WINCHESTER ST STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84107-8513
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-485-6166
Provider Business Mailing Address Fax Number:
801-531-1949

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
929 NW 16TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRUITLAND
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83619-2256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-642-1838
Provider Business Practice Location Address Fax Number:
888-572-2145
Provider Enumeration Date:
06/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LISKEY
Authorized Official First Name:
BREEZIE
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF OPERATIONS
Authorized Official Telephone Number:
801-456-7874

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HH-112 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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