Provider Demographics
NPI:1619514346
Name:INTERMOUNTAIN HOME COMPANIONS D/B/A INTERMOUNTAIN HOME HEALTH
Entity Type:Organization
Organization Name:INTERMOUNTAIN HOME COMPANIONS D/B/A INTERMOUNTAIN HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,CEO,AGENCY
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BICKELS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN,RN
Authorized Official - Phone:307-267-0501
Mailing Address - Street 1:P.O. BOX 1648
Mailing Address - Street 2:
Mailing Address - City:MILLS
Mailing Address - State:WY
Mailing Address - Zip Code:82644
Mailing Address - Country:US
Mailing Address - Phone:307-337-2772
Mailing Address - Fax:307-337-2773
Practice Address - Street 1:800 WERNER CT STE 125
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-1323
Practice Address - Country:US
Practice Address - Phone:307-337-2772
Practice Address - Fax:307-337-2773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care