NPIMap

Organization Active NPI

Glacier Peak Healthcare, Inc.

Doing business as Alpha Home Health, King County

  • Home Health Agency
  • Everett, WA
National Provider Identifier
1871351361
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GLACIER PEAK HEALTHCARE, INC.
Doing business as
Alpha Home Health, King County
Practice address
10530 19TH Ave SE Ste 201D
Everett, WA 98208-4282
Phone
(425) 357-1790
NPI assigned
Mar 8, 2024
Last updated
Jul 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Lee Johnson
Title
Treasurer
Phone
(208) 401-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

10530 19TH Ave SE Ste 201D
Everett, WA 98208-4282

Mailing address

10530 19TH Ave SE Ste 201D
Everett, WA 98208-4282
Phone (425) 357-1790

Other names 1

  • Alpha Home Health, King County Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240608000010 WA Part A Provider - Home Health Agency 8820363369 Practice locations: Everett, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871351361. Details of each certification follow.

Home health agency certification: CCN 507125

Legal name
GLACIER PEAK HEALTHCARE INC
Doing business as
ALPHA HOME HEALTH, KING COUNTY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 15, 2015
Last certification
Jun 15, 2015
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Aug 3, 2017 in NV
Enrollment address
10530 19TH Ave SE
Ste 201D
Everett, WA 98208-4282
HHA Branch

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Alpha Home Health, King CountyCCN 507125 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Jun 15, 2015
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
Alpha Home Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

10530 19th Ave SE
Ste 201D
Everett, WA 98208
Phone (425) 357-1790

2021 E College Way
Ste 201
Mount Vernon, WA 98273
Phone (425) 357-1790

2210 Kulshan View Dr
Ste 105
Mount Vernon, WA 98273
Phone (360) 424-5175

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 12, 2024 100%
Brent Mills Individual Corporate OfficerTreasurer Mar 25, 2026
Gurpreet Dhillon Individual W-2 Managing EmployeeAd; Mar 3, 2026
Brent Guerisoli Individual Corporate DirectorDirector and Sole Board Member Apr 12, 2024
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Apr 12, 2024 100%
John J Gochnour Individual Corporate OfficerPresident/Manager Jul 31, 2025
Amber Tueller Individual Corporate OfficerSecretary Mar 25, 2026

Facilities with the same owner 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 141

NPI Registry JSON

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1871351361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10530 19TH AVE SE STE 201D",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084282",
            "telephone_number": "425-357-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10530 19TH AVE SE STE 201D",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084282",
            "telephone_number": "425-357-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER PEAK HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "208-401-1400"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpha Home Health, King County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.