Active NPI
Addus Healthcare (Idaho), Inc.
- Home Health Agency
- Coeur D Alene, ID
National Provider Identifier
1790718781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- HH-229
- Legal business name
- ADDUS HEALTHCARE (IDAHO), INC.
- Practice address
- 233 E Locust Ave
Coeur D Alene, ID 83814-5748 - Phone
- (208) 765-8016
- Fax
- (208) 765-0690
- NPI assigned
- Jul 10, 2006
- Organization subpart
- Yes
- Parent organization
- ADDUS HEALTHCARE, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Diane Kumarich, RN, MS, MBA
- Title
- National Contracts
- Phone
- (847) 303-5300
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | HH229 | ID | |
| Home Health Agency | 251E00000X | HH-229 | ID | Primary |
Addresses
Primary practice location
233 E Locust Ave
Coeur D Alene, ID 83814-5748
Mailing address
2401 S Plum Grove Rd
Palatine, IL 60067-7486
Phone (847) 303-5300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807484500 | Medicaid | ID |
Other names 1
- A Full Life Health Care Inc.
National Provider Directory
National Provider Directory- Part of
- Addus Healthcare Inc
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
916 W Ironwood Dr
#A
Coeur D Alene, ID 83814
Phone (208) 762-4214
233 E Locust Ave
Coeur D Alene, ID 83814
Phone (208) 765-8016
2401 Plum Grove Rd
Rolling Meadows, IL 60067
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1274832000000",
"number": "1790718781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 S PLUM GROVE RD",
"city": "PALATINE",
"state": "IL",
"postal_code": "600677486",
"telephone_number": "847-303-5300",
"fax_number": "847-303-5435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 E LOCUST AVE",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838145748",
"telephone_number": "208-765-8016",
"fax_number": "208-765-0690"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADDUS HEALTHCARE (IDAHO), INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ADDUS HEALTHCARE, INC.",
"enumeration_date": "2006-07-10",
"last_updated": "2010-05-26",
"status": "A",
"authorized_official_last_name": "KUMARICH",
"authorized_official_first_name": "DIANE",
"authorized_official_title_or_position": "NATIONAL CONTRACTS",
"authorized_official_telephone_number": "847-303-5300",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "RN, MS, MBA"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "ID",
"license": "HH229",
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "ID",
"license": "HH-229",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807484500",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "A Full Life Health Care Inc.",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.