Provider Demographics
NPI:1437927878
Name:YOUR HOME LLC
Entity Type:Organization
Organization Name:YOUR HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STORM
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:971-281-8518
Mailing Address - Street 1:2855 E HAYES ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-1390
Mailing Address - Country:US
Mailing Address - Phone:971-281-8518
Mailing Address - Fax:503-487-6751
Practice Address - Street 1:2855 E HAYES ST STE 100
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1390
Practice Address - Country:US
Practice Address - Phone:971-281-8518
Practice Address - Fax:503-487-6751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care