Alpowa Healthcare, Inc.
Organization Active NPI Home Health Agency · Lewiston, ID
NPI 1134899719 · NPPES record last updated May 27, 2025
Key facts
- NPI
- 1134899719
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- ALPOWA HEALTHCARE, INC.
- Practice address
- 504 Main St Ste 422
Lewiston, ID 83501-1869 - Phone
- (509) 758-2568
- Fax
- (509) 758-3413
- NPI assigned
- Sep 15, 2021
- Organization subpart
- No
Authorized official
- Name
- Amber L Tueller
- Title
- Secretary
- Phone
- (208) 207-2726
Owners & managing parties with NPI records 1
Other NPIs with the same Medicare PAC ID 1
Facilities with the same owner 141
Affiliated clinicians 45
-
Carson E Barnes, MD
-
Chuck R Colas, DO
-
Jessica Alexandra Cruz, MPAS, PA-C
-
Peter James Cunningham, PA-C
-
Ryan Joseph Daly, DNP
-
Tamara Dawn Demean, NP-C
-
Tracy Streibick Flynn, FNP, NP-C
-
Abby Marie Gardner, M.D.
-
Thad Giblette, FNP
-
Donald J Greggain, M.D.
-
Cody Bryan Harris, CNP
-
Sarah Manning Knewbow, FNP-C
-
Ann Lima, MD
-
James F Maguire, DO
-
Cheryl A Mallory, MD
-
Patricia N. Marciano, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Elite Home Health
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- -
- Certified
- Aug 2, 2024
- Medicare certification status
- Active
Medicare Care Compare: Hospice
- Listed as
- Elite Hospice
- Certified
- Aug 2, 2024
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D2274411 | Alpowa Healthcare Inc | Certificate of waiver | Jan 3, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ID
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
- Corporation · Proprietary
- 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
- Corporation · Proprietary
- Incorporated
- Jan 7, 2013 in NV
- Enrollment address
- 504 Main St
Ste 422
Lewiston, ID 83501-1869
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Kyle Ambrose |
W-2 Managing Employee |
Jul 1, 2022 | |
| Paragon Healthcare, Inc. |
5% Or Greater Direct Ownership Interest | Jan 7, 2013 | 100% |
| Cornerstone Healthcare Inc |
5% Or Greater Indirect Ownership Interest | Jan 7, 2013 | 100% |
| Brent Mills |
Corporate Officer |
Mar 25, 2026 | |
| Brent Guerisoli |
Corporate Director |
Jan 4, 2025 | |
| Corporate Director |
Jan 10, 2023 | ||
| The Pennant Group Inc |
5% Or Greater Indirect Ownership Interest | Oct 1, 2019 | 100% |
| John J Gochnour |
Corporate Officer |
Jan 4, 2025 | |
| Corporate Officer |
Jan 15, 2024 | ||
| Amber Tueller |
Corporate Officer |
Jan 4, 2025 | |
| Elizabeth Lefft Black |
Contracted Managing Employee |
Feb 13, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220815001027 | ID | Part a Provider - Hospice | 5496992125 | Practice locations: Lewiston, ID |
| O20230614001434 | ID | Part a Provider - Home Health Agency | 5496992125 | Practice locations: Lewiston, ID |
National Provider Directory
Locations
1370 Bridge St
Clarkston, WA 99403
Phone (509) 758-2568
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes | ||
| 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
- Elite Home Health and Hospice
Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2025. 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.