Portneuf Home Health Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HH-106 Issued in ID

Legal business name

PORTNEUF HOME HEALTH CARE, LLC

Practice address

1111 North 8TH Street
Suite B
Pocatello, ID 83201-5789

Phone

(208) 233-2137

Fax

(208) 233-2982

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. William F Borne

Title

Ceo

Phone

(225) 292-2031

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Portneuf Home Health Care Doing business as

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1720138563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 SOUTH SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-292-2031",
            "fax_number": "225-295-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 NORTH 8TH STREET",
            "address_2": "SUITE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015789",
            "telephone_number": "208-233-2137",
            "fax_number": "208-233-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTNEUF HOME HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "BORNE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-292-2031",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "ID",
            "license": "HH-106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807770600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portneuf Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Pocatello, ID
• Home Health Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; 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.