Atlas Home Care LLC

Key facts

NPI

1295581080

Entity type

Organization (NPI type 2)

Primary specialty

Home Health Agency 251E00000X

Legal business name

ATLAS HOME CARE LLC

Practice address

4627 W Farm View Dr
Boise, ID 83714-9325

Phone

(208) 283-9130

NPI assigned

Apr 24, 2024

Organization subpart

No

Authorized official

Name

Kenneth Waterman

Title

Owner

Phone

(208) 283-9130

National Provider Directory

Specialties & licenses

Addresses

Other names

• Atlas Home Care Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 24, 2024.

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1295581080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4627 W FARM VIEW DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837149325",
            "telephone_number": "208-283-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4627 W FARM VIEW DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837149325",
            "telephone_number": "208-283-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-283-9130"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlas Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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