NPIMap

Organization Active NPI

Alpowa Healthcare, Inc.

Doing business as Elite Home Health and Hospice

  • Home Health Agency
  • Lewiston, ID
National Provider Identifier
1134899719
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ALPOWA HEALTHCARE, INC.
Doing business as
Elite Home Health and Hospice
Practice address
504 Main St Ste 422
Lewiston, ID 83501-1869
Phone
(509) 758-2568
Fax
(509) 758-3413
NPI assigned
Sep 15, 2021
Last updated
May 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Community Based Hospice Care Agency 251G00000X
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

504 Main St Ste 422
Lewiston, ID 83501-1869

Mailing address

504 Main St Ste 422
Lewiston, ID 83501-1869
Phone (509) 758-2568

Other names 1

  • Elite Home Health and Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220815001027 ID Part A Provider - Hospice 5496992125 Practice locations: Lewiston, ID
O20230614001434 ID Part A Provider - Home Health Agency 5496992125 Practice locations: Lewiston, ID

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1134899719. Details of each certification follow.

Hospice certification: CCN 131591

Legal name
ALPOWA HEALTHCARE, INC.
Doing business as
ELITE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 2, 2024
Last certification
Jul 17, 2024
Organization structure
CorporationProprietary
Enrollment address
504 Main St
Ste 422
Lewiston, ID 83501-1869

Home health agency certification: CCN 137303

Legal name
ALPOWA HEALTHCARE, INC.
Doing business as
ELITE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 2, 2024
Last certification
Jul 17, 2024
Organization structure
CorporationProprietary
Incorporated
Jan 7, 2013 in NV
Enrollment address
504 Main St
Ste 422
Lewiston, ID 83501-1869

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Elite Home HealthCCN 137303 · All quality measures
Overall star rating
3.5 of 5
Ownership
-
Certified
Aug 2, 2024
Medicare certification status
ActiveFrom the Provider of Services file

Care Compare: Hospice

Medicare Care Compare
Listed as
Elite HospiceCCN 131591 · All quality measures
Certified
Aug 2, 2024
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2274411Alpowa Healthcare Inc504 Main St Ste 422, Lewiston, ID 83501Certificate of waiverJan 3, 2027

National Provider Directory

National Provider Directory

Locations

504 Main St
Ste 422
Lewiston, ID 83501
Phone (509) 710-8171

1370 Bridge St
Clarkston, WA 99403
Phone (509) 758-2568

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Kyle Ambrose Individual W-2 Managing EmployeeAdministrator Jul 1, 2022
Paragon Healthcare, Inc. Organization, Eagle, ID Corporation 5% Or Greater Direct Ownership Interest Jan 7, 2013 100%
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jan 7, 2013 100%
Brent Mills Individual Corporate OfficerTreasurer Mar 25, 2026
Brent Guerisoli Individual Corporate DirectorDirector Jan 4, 2025
Corporate DirectorDirector and Sole Board Member Jan 10, 2023
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2019 100%
John J Gochnour Individual Corporate OfficerPresident/LLC Manager Jan 4, 2025
Corporate OfficerPresident Jan 15, 2024
Amber Tueller Individual Corporate OfficerSecretary Jan 4, 2025
Elizabeth Lefft Black Individual Contracted Managing EmployeeMD; Feb 13, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 141

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

View all 141

Practitioners & affiliated clinicians

Affiliated clinicians 45

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

View all 45

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1134899719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 MAIN ST STE 422",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011869",
            "telephone_number": "509-758-2568",
            "fax_number": "509-758-3413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 MAIN ST STE 422",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011869",
            "telephone_number": "509-758-2568",
            "fax_number": "509-758-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPOWA HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-15",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Home Health and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.