Provider Demographics
NPI:1679467492
Name:SEQUOIA HOME HEALTH LLC
Entity type:Organization
Organization Name:SEQUOIA HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODFELLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-631-4300
Mailing Address - Street 1:16924 BUTTERFLY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83607-8859
Mailing Address - Country:US
Mailing Address - Phone:208-230-0314
Mailing Address - Fax:
Practice Address - Street 1:7070 S UNION PARK AVE STE 300
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-6061
Practice Address - Country:US
Practice Address - Phone:801-421-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health