Care at Home, Inc.
Organization Active NPI Home Health Agency · Fruitland, ID
NPI 1831135474 · NPPES record last updated May 1, 2025
Key facts
- NPI
- 1831135474
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- HH-112 (ID)
- Legal business name
- CARE AT HOME, INC.
- Practice address
- 929 NW 16TH St
Fruitland, ID 83619-2256 - Phone
- (208) 642-1838
- Fax
- (888) 572-2145
- NPI assigned
- Jun 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Breezie Liskey
- Title
- VP of Operations
- Phone
- (801) 456-7874
Owners & managing parties with NPI records 1
Member of 1
Affiliated clinicians 24
-
Jordan V Blanchard, M.D.
-
Isaac L Elam, MD
-
Zachary Friberg, NP
-
Suzanna Dyann Hubele, M.D.
-
Janeen D. Jenkins, PA-C
-
Caleb Patee, D.O.
-
Jeanette Hazel Marie Reiners, DNP, FNP
-
Sheridan Shaw, DNP, NP-C
-
Andrew Silsby, FNP-C
-
Jocele Skinner, MD
-
Jeremy Sloyer, FNP-BC
-
Melissa A Walsh, PA-C
-
Lore Beth Wootton, M.D.
-
Sarah Beth Chandler, DNP
-
Ryan James David, D.O.
-
Brett C Johnson, D.O.
Medicare Care Compare: Home health agency
- Listed as
- Canyon Home Care & Hospice
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Proprietary
- Certified
- Dec 21, 1993
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Home health agency certification: CCN 137068
- Legal name
- CARE AT HOME, INC
- Doing business as
- CANYON HOME CARE & HOSPICE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 21, 1993
- Last certification
- Dec 10, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Feb 13, 2004 in ID
- Enrollment address
- 929 NW 16TH St
Fruitland, ID 83619-2256
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Kenneth Edwin Norris |
5% Or Greater Indirect Ownership Interest |
Dec 1, 2016 | 50% |
| Corporate Officer | Dec 1, 2016 | 100% | |
| Operational/Managerial Control |
Dec 1, 2016 | 100% | |
| Tyson Cichos |
5% Or Greater Indirect Ownership Interest | Dec 11, 2016 | 25% |
| Cory R Robison |
5% Or Greater Indirect Ownership Interest | Dec 1, 2016 | 25% |
| Matthew Marakis |
W-2 Managing Employee |
Nov 11, 2024 | 100% |
| Canyon Idaho Home Care & Hospice LLC |
5% Or Greater Direct Ownership Interest | Dec 1, 2016 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090126000312 | ID | Part a Provider - Home Health Agency | 8527122266 | Practice locations: Fruitland, ID; Meridian, ID |
National Provider Directory
Locations
746 E Winchester St
Ste 200
Salt Lake City, UT 84107
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | HH-112 | ID | Yes |
Addresses
Primary practice location
929 NW 16TH St
Fruitland, ID 83619-2256
Mailing address
746 E Winchester St Ste 200
Salt Lake City, UT 84107-8513
Phone (801) 485-6166
Other practice location 1
2440 S Titanium Pl
Meridian, ID 83642-6703
Phone (208) 453-2659
Other names
- Canyon Home Care & Hospice
Other providers in Fruitland, ID
- Emily Burnett
- Terry A. Buster
- Nani Jane Cabrera
- Columbus Candies
- Canyon Idaho Home Care & Hospice, LLC
- Care Continuum, Inc.
- Cej Supply LLC
- Childrens Dentistry of Fruitland
- David M. Christensen
- Mark David Christenson
All providers in Fruitland, ID · Home Health Agency in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.