Provider Demographics
NPI:1922252790
Name:PEREGRINE HOME HEALTH LLC
Entity Type:Organization
Organization Name:PEREGRINE HOME HEALTH LLC
Other - Org Name:AFI ADVANCED CARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:VINING
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:801-546-7417
Mailing Address - Street 1:1133 N MAIN ST # 300
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-4800
Mailing Address - Country:US
Mailing Address - Phone:801-546-7417
Mailing Address - Fax:801-546-5230
Practice Address - Street 1:1133 N MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-4800
Practice Address - Country:US
Practice Address - Phone:801-546-7417
Practice Address - Fax:801-546-5230
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEREGRINE HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-06
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health