Provider Demographics
NPI:1396934469
Name:APPLEGATE HOMECARE & HOSPICE, LLC
Entity type:Organization
Organization Name:APPLEGATE HOMECARE & HOSPICE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-621-6950
Mailing Address - Street 1:1740 COMBE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-5037
Mailing Address - Country:US
Mailing Address - Phone:801-621-4027
Mailing Address - Fax:
Practice Address - Street 1:8836 N HESS ST
Practice Address - Street 2:SUITE A
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-8718
Practice Address - Country:US
Practice Address - Phone:208-762-7825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAYWEST INVESTMENTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-15
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
131557Medicare Oscar/Certification