NPIMap

Organization Active NPI

Addus Healthcare (Idaho), Inc

  • In Home Supportive Care Agency
  • Lewiston, ID
National Provider Identifier
1154542165
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
ADDUS HEALTHCARE (IDAHO), INC
Practice address
1037A 21St St
Lewiston, ID 83501-3415
Phone
(208) 746-8881
Fax
(855) 808-6973
NPI assigned
May 1, 2007
Organization subpart
Yes
Parent organization
ADDUS HEALTH CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Authorized official

Name
Darby Anderson
Title
Evp, Chief Strategy Officer
Phone
(630) 296-3443

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

1037A 21St St
Lewiston, ID 83501-3415

Mailing address

801 Warrenville Rd Ste 800
Lisle, IL 60532-0912
Phone (630) 296-3400

Other identifiers 1

IdentifierTypeStateIssuer
806412200OtherIDLEWISTON - DDRN

Other names 1

  • Addus HomeCare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Addus Healthcare Idaho Inc7 organizations share this tax ID, including this one
Part of
Addus Healthcare Inc

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1154542165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 WARRENVILLE RD STE 800",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605320912",
            "telephone_number": "630-296-3400",
            "fax_number": "630-487-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037A 21ST ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835013415",
            "telephone_number": "208-746-8881",
            "fax_number": "855-808-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDUS HEALTHCARE (IDAHO), INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADDUS HEALTH CARE INC",
        "enumeration_date": "2007-05-01",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DARBY",
        "authorized_official_title_or_position": "EVP, CHIEF STRATEGY OFFICER",
        "authorized_official_telephone_number": "630-296-3443"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEWISTON - DDRN",
            "identifier": "806412200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Addus HomeCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Addus HomeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.