Hospice Alliance Of Idaho, LLC
Hospice Care, Community Based in Idaho Falls, ID. Organization (NPI-2).
NPI number1730294463
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1730294463
- Entity type
- Organization (NPI-2)
- Legal business name
- Hospice Alliance Of Idaho, LLC
- Organization subpart
- No
- Enumeration date
- Aug 21, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251G00000X | Hospice Care, Community Based | – | – | Yes |
Practice location
1270 S Woodruff AveIdaho Falls, ID 83404-5544
Phone 208-552-0249 · Fax 208-552-6172
Mailing address
965 S 100 WSuite 204
Logan, UT 84321-6062
Phone 435-753-0707 · Fax 435-755-8505
Authorized official
Justin Larsen
Owner/Ceo
4357530707
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