NPIMap

Organization Active NPI

Multicare Home Health Services, Inc.

  • Home Health Agency
  • Meridian, ID
National Provider Identifier
1831182278
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HH212 Issued in ID
Legal business name
MULTICARE HOME HEALTH SERVICES, INC.
Practice address
324 S Meridian Rd
Suite10
Meridian, ID 83642-2959
Phone
(208) 884-5497
Fax
(208) 887-6498
NPI assigned
Aug 30, 2005
Last updated
Aug 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Authorized official

Name
Mrs. Mary L. Wallis
Title
Vice-President
Phone
(208) 884-5497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HH212 ID Primary

Addresses

Primary practice location

324 S Meridian Rd
Suite10
Meridian, ID 83642-2959

Mailing address

324 S Meridian Rd
Suite10
Meridian, ID 83642-2959
Phone (208) 884-5497

Other identifiers 1

IdentifierTypeStateIssuer
805930400MedicaidID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100706000764 ID Part A Provider - Home Health Agency 3476684549 Practice locations: Meridian, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831182278. Details of each certification follow.

Home health agency certification: CCN 137093

Legal name
MULTICARE HOME HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 18, 1996
Last certification
Nov 2, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Nov 29, 1999 in ID
Enrollment address
324 S Meridian Rd
Ste 10
Meridian, ID 83642-2900

Care Compare: Home health agency

Medicare Care Compare
Listed as
Multicare Home Health Services, IncCCN 137093 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Mar 18, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Multi-Care Home Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

324 S Meridian Rd
Ste 10
Meridian, ID 83642
Phone (208) 884-5497

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
Robin R Wallis Individual 5% Or Greater Direct Ownership InterestOwner/President Nov 29, 1999 50%
Corporate OfficerOwner/President Nov 29, 1999 50%
Corporate DirectorOwner/President Nov 29, 1999 50%
W-2 Managing EmployeeOwner/President Nov 29, 1999 50%
OtherOwner Nov 29, 1999 50%
Mary L Wallis Individual 5% Or Greater Direct Ownership InterestCfo Nov 29, 1999 50%
Corporate OfficerCfo Nov 29, 1999 50%
Corporate DirectorCfo Nov 29, 1999 50%
W-2 Managing EmployeeCfo Nov 29, 1999 50%
OtherCfo Nov 29, 1999 50%

Practitioners & affiliated clinicians

Affiliated clinicians 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1831182278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 S MERIDIAN RD",
            "address_2": "SUITE10",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422959",
            "telephone_number": "208-884-5497",
            "fax_number": "208-887-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 S MERIDIAN RD",
            "address_2": "SUITE10",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422959",
            "telephone_number": "208-884-5497",
            "fax_number": "208-887-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULTICARE HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "208-884-5497",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "ID",
            "license": "HH212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805930400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.