Provider Demographics
NPI:1790833861
Name:INTERMOUNTAIN HOME HEALTH INC
Entity Type:Organization
Organization Name:INTERMOUNTAIN HOME HEALTH INC
Other - Org Name:SUMMIT HOME HEALTH LAYTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BRITSCH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:801-542-7150
Mailing Address - Street 1:2086 ROBINS DR SUITE B
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-1132
Mailing Address - Country:US
Mailing Address - Phone:801-825-2655
Mailing Address - Fax:801-825-2655
Practice Address - Street 1:2086 ROBINS DR SUITE B
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1132
Practice Address - Country:US
Practice Address - Phone:801-825-2655
Practice Address - Fax:801-825-2655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT467235Medicare ID - Type UnspecifiedHOME HEALTH CARE