Provider Demographics
NPI:1821374117
Name:CASCADE SPRINGS HOME HEALTH & HOSPICE, LLC
Entity Type:Organization
Organization Name:CASCADE SPRINGS HOME HEALTH & HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:PETTIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-614-5700
Mailing Address - Street 1:PO BOX 160528
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84016-0528
Mailing Address - Country:US
Mailing Address - Phone:801-614-5700
Mailing Address - Fax:801-546-1053
Practice Address - Street 1:1795 CHELEMES WAY
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-6298
Practice Address - Country:US
Practice Address - Phone:801-614-5700
Practice Address - Fax:801-546-1053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based