Provider Demographics
NPI:1720602816
Name:ANN HOME CARE LLC
Entity Type:Organization
Organization Name:ANN HOME CARE LLC
Other - Org Name:ANN'S HOME CARE LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YANHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-819-8696
Mailing Address - Street 1:42565 SILVER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:ID
Mailing Address - Zip Code:83839-9736
Mailing Address - Country:US
Mailing Address - Phone:208-819-8696
Mailing Address - Fax:
Practice Address - Street 1:42565 SILVER VALLEY RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:ID
Practice Address - Zip Code:83839-9736
Practice Address - Country:US
Practice Address - Phone:208-819-8696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health