Hospice Alliance of Idaho, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HOSPICE ALLIANCE OF IDAHO, LLC

Practice address

1270 S Woodruff Ave
Idaho Falls, ID 83404-5544

Phone

(208) 552-0249

Fax

(208) 552-6172

NPI assigned

Aug 21, 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. Justin Larsen

Title

Owner/Ceo

Phone

(435) 753-0707

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730294463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 S 100 W",
            "address_2": "SUITE 204",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843216062",
            "telephone_number": "435-753-0707",
            "fax_number": "435-755-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045544",
            "telephone_number": "208-552-0249",
            "fax_number": "208-552-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE ALLIANCE OF IDAHO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "435-753-0707",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Horne, MD
• Gavin Horne
• Bonnie Horsburgh, LMSW
• Jennifer Horton, PHARM.D.
• Miranda Hosking, OTR/L
• Hospice of Eastern Idaho, Inc.
• Hospice of Eastern Idaho, Inc.
• House of Hearts ABA
• Cameron Keith Housley, OD
• Nathan Housley, OD

• Community Based Hospice Care Agency in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Community Based Hospice Care Agency in Idaho

• 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.