Provider Demographics
NPI:1609548031
Name:HOME HEALTH OF NORTHWEST, LLC
Entity Type:Organization
Organization Name:HOME HEALTH OF NORTHWEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-896-8847
Mailing Address - Street 1:55930 BLUE EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97707-2369
Mailing Address - Country:US
Mailing Address - Phone:541-640-2518
Mailing Address - Fax:541-550-2919
Practice Address - Street 1:55930 BLUE EAGLE RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97707-2369
Practice Address - Country:US
Practice Address - Phone:541-640-2518
Practice Address - Fax:541-550-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-04
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health