Provider Demographics
NPI:1902784119
Name:CC HOME HEALTH CHOICES, LLC
Entity type:Organization
Organization Name:CC HOME HEALTH CHOICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:208-993-8050
Mailing Address - Street 1:404 COURTHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:SALMON
Mailing Address - State:ID
Mailing Address - Zip Code:83467-3341
Mailing Address - Country:US
Mailing Address - Phone:208-993-3479
Mailing Address - Fax:
Practice Address - Street 1:404 COURTHOUSE DR
Practice Address - Street 2:
Practice Address - City:SALMON
Practice Address - State:ID
Practice Address - Zip Code:83467-3341
Practice Address - Country:US
Practice Address - Phone:208-993-3479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CC HOME HEALTH CHOICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care