Provider Demographics
NPI:1427432467
Name:HOME CAREGIVERS PARTNERSHIP LLC
Entity type:Organization
Organization Name:HOME CAREGIVERS PARTNERSHIP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BREEZIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LISKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-456-7874
Mailing Address - Street 1:450 S 900 E
Mailing Address - Street 2:STUITE 100
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2981
Mailing Address - Country:US
Mailing Address - Phone:801-485-6166
Mailing Address - Fax:801-531-1949
Practice Address - Street 1:1680 W HIGHWAY 40 STE 205
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-4142
Practice Address - Country:US
Practice Address - Phone:435-781-6566
Practice Address - Fax:435-781-6567
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME CAREGIVERS PARTNERSHIP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-18
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
UT2014HOSPICEUT000591251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT461603Medicare PIN
UT292194Medicare UPIN