Provider Demographics
NPI:1558369256
Name:IDAHO HOME HEALTH & HOSPICE, INC.
Entity Type:Organization
Organization Name:IDAHO HOME HEALTH & HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-734-4061
Mailing Address - Street 1:826 EASTLAND DR
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6858
Mailing Address - Country:US
Mailing Address - Phone:208-734-4061
Mailing Address - Fax:208-733-5980
Practice Address - Street 1:826 EASTLAND DR
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6858
Practice Address - Country:US
Practice Address - Phone:208-734-4061
Practice Address - Fax:208-733-5980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDHH/142251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID137014Medicare Oscar/Certification