Provider Demographics
NPI:1285930172
Name:HOME HEALTH SERVICES OF IDAHO LLC
Entity type:Organization
Organization Name:HOME HEALTH SERVICES OF IDAHO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-938-9681
Mailing Address - Street 1:1065 E WINDING CREEK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-7243
Mailing Address - Country:US
Mailing Address - Phone:208-938-9681
Mailing Address - Fax:208-515-7957
Practice Address - Street 1:1065 E WINDING CREEK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-7243
Practice Address - Country:US
Practice Address - Phone:208-938-9681
Practice Address - Fax:208-515-7957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health