A Full Life Agency

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

A FULL LIFE AGENCY

Practice address

9075 N Government Way
Hayden, ID 83835-9217

Phone

(208) 762-9835

Fax

(208) 762-0935

NPI assigned

Nov 1, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Donald D Gross

Title

President

Phone

(208) 762-5433

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346327194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9297 N GOVERNMENT WAY STE C",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359290",
            "telephone_number": "208-762-5433",
            "fax_number": "208-209-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9075 N GOVERNMENT WAY",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359217",
            "telephone_number": "208-762-9835",
            "fax_number": "208-762-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A FULL LIFE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-762-5433",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.