Provider Demographics
NPI:1154428944
Name:JOURNEYS HOSPICE, INC
Entity type:Organization
Organization Name:JOURNEYS HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:208-870-4691
Mailing Address - Street 1:223 E AMITY AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5707
Mailing Address - Country:US
Mailing Address - Phone:208-461-3035
Mailing Address - Fax:208-466-0693
Practice Address - Street 1:223 E AMITY AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-5707
Practice Address - Country:US
Practice Address - Phone:208-461-3035
Practice Address - Fax:208-466-0693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010060787OtherREGENCY BLUE SHIELD OF ID
ID131555Medicare ID - Type UnspecifiedHOSPICE PROVIDER NO.
ID1910015Medicare Oscar/Certification