Provider Demographics
NPI:1306946462
Name:ENVISION HOME HEALTH LLC
Entity type:Organization
Organization Name:ENVISION HOME HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SHERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-225-7971
Mailing Address - Street 1:1345 W 1600 N # 202
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2431
Mailing Address - Country:US
Mailing Address - Phone:801-225-7971
Mailing Address - Fax:866-660-0101
Practice Address - Street 1:990 W ATHERTON DR STE 100
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-3465
Practice Address - Country:US
Practice Address - Phone:801-359-7600
Practice Address - Fax:866-660-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2007-HOSPICE-80460251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1306946462Medicaid