Organization Active NPI

Salmon Valley Home Health LLC

  • Home Health Agency
  • Salmon, ID
National Provider Identifier
1619467149
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SALMON VALLEY HOME HEALTH LLC
Practice address
404 Courthouse Dr
Salmon, ID 83467-3341
Phone
(208) 993-8050
Fax
(208) 993-8046
NPI assigned
May 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Cindy L Clark
Title
Owner/Administrator
Phone
(208) 993-3479

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

404 Courthouse Dr
Salmon, ID 83467-3341

Mailing address

404 Courthouse Dr
Salmon, ID 83467-3341
Phone (208) 993-8050

Other practice location 1

1142 Ruth Ann Dr
Blackfoot, ID 83221-3663
Phone (208) 993-8050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190405000212 ID Part A Provider - Home Health Agency 1052655933 Practice locations: Salmon, ID

Home health agency certification: CCN 137141

Legal name
SALMON VALLEY HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 24, 2020
Last certification
Apr 24, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Apr 1, 2018 in ID
Enrollment address
404 Courthouse Dr
Salmon, ID 83467-3341

Care Compare: Home health agency

Medicare Care Compare
Listed as
Salmon Valley Home Health LLCCCN 137141
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Apr 24, 2020
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide

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
13D2210248Salmon Valley Home Health LLC404 Courthouse Dr, Salmon, ID 83467Certificate of waiverJan 19, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Cindy L Clark Individual 5% Or Greater Direct Ownership Interest Aug 1, 2018 51%
Corporate OfficerPresident of the Board Aug 1, 2018 100%
Corporate DirectorPresident of the Board, Director Aug 1, 2018 100%
Operational/Managerial ControlAdministrator, Director of Nursi Aug 1, 2018 100%
William V Clark Individual 5% Or Greater Direct Ownership Interest Aug 1, 2018 49%
Corporate OfficerBoard Member Aug 1, 2018 25%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1619467149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 COURTHOUSE DR",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834673341",
            "telephone_number": "208-993-8050",
            "fax_number": "208-993-8046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 COURTHOUSE DR",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834673341",
            "telephone_number": "208-993-8050",
            "fax_number": "208-993-8046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1142 Ruth Ann Dr",
            "address_purpose": "LOCATION",
            "city": "Blackfoot",
            "state": "ID",
            "postal_code": "832213663",
            "country_code": "US",
            "telephone_number": "208-993-8050",
            "fax_number": "208-993-8046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SALMON VALLEY HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "208-993-3479"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salmon, ID

Sources for this page

Verify at the official NPI Registry.