Provider Demographics
NPI:1740993732
Name:ZION HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:ZION HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMESETTA
Authorized Official - Middle Name:KAIDDY
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-793-3297
Mailing Address - Street 1:4902 16TH AVE S APT 308
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-8946
Mailing Address - Country:US
Mailing Address - Phone:701-793-3297
Mailing Address - Fax:
Practice Address - Street 1:4902 16TH AVE S APT 308
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-8946
Practice Address - Country:US
Practice Address - Phone:701-793-3297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health