Provider Demographics
NPI:1568980985
Name:ACHS HOSPICE & PALLITIVE CARE LLC
Entity Type:Organization
Organization Name:ACHS HOSPICE & PALLITIVE CARE LLC
Other - Org Name:CARING EDGE O P
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PT/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUGHEED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:208-473-2717
Mailing Address - Street 1:815 S BRIDGE WAY PL STE 122
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-6022
Mailing Address - Country:US
Mailing Address - Phone:208-473-2717
Mailing Address - Fax:877-890-5617
Practice Address - Street 1:815 S BRIDGE WAY PL STE 122
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-6022
Practice Address - Country:US
Practice Address - Phone:208-473-2717
Practice Address - Fax:877-890-5617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-3215225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDPT-3215OtherID LICENSE