Provider Demographics
NPI:1912917329
Name:ADVANCED HOME HEALTH INCORPORATED
Entity Type:Organization
Organization Name:ADVANCED HOME HEALTH INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ECONOMON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:208-665-5579
Mailing Address - Street 1:1015 W IRONWOOD DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4952
Mailing Address - Country:US
Mailing Address - Phone:208-765-2140
Mailing Address - Fax:208-665-5559
Practice Address - Street 1:1015 W IRONWOOD DR
Practice Address - Street 2:SUITE 100
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4952
Practice Address - Country:US
Practice Address - Phone:208-765-2140
Practice Address - Fax:208-665-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health