Provider Demographics
NPI:1043775208
Name:AT HOME CARE AND HOME HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:AT HOME CARE AND HOME HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-494-6775
Mailing Address - Street 1:929 W SUNSET BLVD STE 21-262
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4865
Mailing Address - Country:US
Mailing Address - Phone:435-494-6775
Mailing Address - Fax:435-652-3675
Practice Address - Street 1:929 W SUNSET BLVD STE 21-262
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4865
Practice Address - Country:US
Practice Address - Phone:435-494-6775
Practice Address - Fax:435-652-3675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT251T00000XMedicaid
UT343900000XMedicaid
UT253Z00000XMedicaid
UT251G00000XMedicaid