Provider Demographics
NPI:1477929776
Name:ADVANCED HOME HEALTH NORTHWEST LLC
Entity Type:Organization
Organization Name:ADVANCED HOME HEALTH NORTHWEST LLC
Other - Org Name:HEALTHY LIVING AT HOME - BEND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-757-2700
Mailing Address - Street 1:2365 NORTHSIDE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-2720
Mailing Address - Country:US
Mailing Address - Phone:888-871-0766
Mailing Address - Fax:866-551-0846
Practice Address - Street 1:1558 SW NANCY WAY STE 104
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3216
Practice Address - Country:US
Practice Address - Phone:541-241-3369
Practice Address - Fax:541-244-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR387160Medicare Oscar/Certification