Provider Demographics
NPI:1427874551
Name:CAMPANIONSHIP HOME CARE
Entity type:Organization
Organization Name:CAMPANIONSHIP HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAIN
Authorized Official - Middle Name:MURHULA
Authorized Official - Last Name:CLEMENTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-609-6006
Mailing Address - Street 1:3432 E SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687-8982
Mailing Address - Country:US
Mailing Address - Phone:747-609-6006
Mailing Address - Fax:
Practice Address - Street 1:3432 E SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-8982
Practice Address - Country:US
Practice Address - Phone:747-609-6006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty