Aspen Home Health Private Duty LLC
Organization Active NPI Home Health Agency · Idaho Falls, ID
NPI 1063568178 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1063568178
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- HH-117 (ID)
- Legal business name
- ASPEN HOME HEALTH PRIVATE DUTY LLC
- Practice address
- 3470 Washington Pkwy
Idaho Falls, ID 83404-7579 - Phone
- (208) 523-9887
- NPI assigned
- Jan 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Robert Collette
- Title
- Member
- Phone
- (208) 523-9887
Facilities with the same owner 10
Medicare Care Compare: Home health agency
- Listed as
- Integricare of Eastern Idaho
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Proprietary
- Certified
- Feb 14, 1991
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Home health agency certification: CCN 137048
- Legal name
- ASPEN HOME HEALTH PRIVATE DUTY LLC
- Doing business as
- INTEGRICARE OF EASTERN IDAHO
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Feb 14, 1991
- Last certification
- May 23, 2013
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Nov 24, 1997 in ID
- Enrollment address
- 3470 Washington Pkwy
Idaho Falls, ID 83404-7579
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Jaimi Ann Willson |
5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 20% |
| Aspen Healthcare Midco Holdings LLC |
5% Or Greater Direct Ownership Interest | Dec 15, 2025 | 100% |
| Deanna Baird |
Contracted Managing Employee |
Dec 15, 2025 | 100% |
| Aspen Healthcare Holdings LLC |
5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 100% |
| Trevor Collette |
5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 20% |
| The Jeffrey and Jaimi Willson Family Trust |
5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 20% |
| Travis Collette |
5% Or Greater Indirect Ownership Interest |
Dec 15, 2025 | 20% |
| Corporate Director |
Dec 15, 2025 | 100% | |
| Derek Paul Collette |
5% Or Greater Indirect Ownership Interest |
Dec 15, 2025 | 20% |
| Corporate Director |
Dec 15, 2025 | 100% | |
| Jared Scott Collette |
5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 20% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20021211000015 | ID | Part a Provider - Home Health Agency | 9830007053 | Practice locations: Idaho Falls, ID |
National Provider Directory
Locations
1443 Parkway Dr
Ste 2
Blackfoot, ID 83221
2236 E 25th St
Idaho Falls, ID 83404
Phone (208) 523-9887
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | HH-117 | ID | Yes |
Addresses
Primary practice location
3470 Washington Pkwy
Idaho Falls, ID 83404-7579
Mailing address
PO Box 3881
Idaho Falls, ID 83403-3881
Other names
- IntegriCare of Eastern Idaho
Other providers in Idaho Falls, ID
- Ashton Memorial, Inc.
- Ashton Memorial, Inc.
- Phillip M Ashton
- Aspen Consulting and Management Services, LLC
- Aspen Developmental Services, Inc.
- Aspen Managment Services Inc
- Aspen Mental Health Services, Inc.
- Aspen Valley Family Dentistry
- Assisted Living Concepts Inc
- Associated Counseling
All providers in Idaho Falls, ID · Home Health Agency in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.