Provider Demographics
NPI:1851303390
Name:TRUE NORTH HOME HEALTH AND HOSPICE LLC
Entity type:Organization
Organization Name:TRUE NORTH HOME HEALTH AND HOSPICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RESOURCE
Authorized Official - Prefix:
Authorized Official - First Name:SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-540-1249
Mailing Address - Street 1:6084 SOUTH SUMMIT VISTA BLVD
Mailing Address - Street 2:UNIT #101
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84129-3216
Mailing Address - Country:US
Mailing Address - Phone:801-922-4790
Mailing Address - Fax:801-922-4790
Practice Address - Street 1:6084 S SUMMIT VISTA BLVD UNIT 101
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84129-3216
Practice Address - Country:US
Practice Address - Phone:801-922-4790
Practice Address - Fax:801-922-4790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2006HHA72900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT467224Medicare ID - Type Unspecified