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Bear River Healthcare LLC

Organization Active NPI Home Health Agency · Brigham City, UT

NPI 1124643499 · NPPES record last updated Jan 23, 2025

Key facts

NPI
1124643499
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
Legal business name
BEAR RIVER HEALTHCARE LLC
Practice address
646 S Main St Ste 105
Brigham City, UT 84302-3273
Phone
(435) 752-2291
NPI assigned
Jun 12, 2020
Organization subpart
No

Authorized official

Name
Amber L Tueller
Title
Secretary
Phone
(208) 207-2726

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Facilities with the same owner 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 141

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Home health agency

Listed as
Symbii Home Health Bear River CCN 467219
Overall star rating
★★★★★ 5 of 5
Ownership
Proprietary
Certified
Jun 9, 2005
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT

Home health agency certification: CCN 467219

Legal name
BEAR RIVER HEALTHCARE LLC
Doing business as
SYMBII HOME HEALTH BEAR RIVER
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 9, 2005
Last certification
Jan 14, 2020
Ownership / control type
Proprietary
Organization structure
LLC · Proprietary
Incorporated
Jun 11, 2020 in NV
Enrollment address
646 S Main St
Ste 105
Brigham City, UT 84302-3273
HHA Branch

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jeremy R Deatry
Individual 		W-2 Managing Employee
Ad;		 Aug 19, 2025
Cornerstone Healthcare Inc
Organization · Eagle, ID
Corporation, For-profit 		5% Or Greater Direct Ownership Interest Jul 1, 2020 100%
Brent Mills
Individual 		Corporate Officer
Treasurer		 Mar 26, 2026
Brent Guerisoli
Individual 		Corporate Director Aug 1, 2022
The Pennant Group Inc
Organization · Eagle, ID
Corporation, For-profit 		5% Or Greater Indirect Ownership Interest Jul 1, 2020 100%
John J Gochnour
Individual 		Corporate Officer
President		 Mar 26, 2026
Amber Tueller
Individual 		Corporate Officer
Secretary		 Apr 10, 2024
Elliot McMillan
Individual 		Corporate Officer
Vice President		 Jul 1, 2020

Change-of-ownership history

DateEventCounterparty
Jul 1, 2020 Change of Ownership
This provider was the buyer		 Signature Healthcare at Home- Nut HH
CCN 467219 · UT · NPI 1902298185

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200806001512 UT Part a Provider - Home Health Agency 9830514983 Practice locations: Brigham City, UT

National Provider Directory

Tax ID family
Bear River Healthcare LLC (2 organizations share this tax ID)

Locations

1153 N Main St
Ste B100110
Logan, UT 84341
Phone (435) 752-2291

Networks

  • UT PPO D-SNP
    Plans: DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) (H4473-004-000, H4473)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

646 S Main St Ste 105
Brigham City, UT 84302-3273

Mailing address

646 S Main St Ste 105
Brigham City, UT 84302-3273
Phone (435) 752-2291

Other names

  • Symbii Home Health Doing business as

Other providers in Brigham City, UT

All providers in Brigham City, UT · Home Health Agency in Utah

Sources for this page

Verify at the official NPI Registry.