Active NPI
Ambrose Healthcare LLC
- Home Health Agency
- Layton, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 2018-HHA-UT000840
- Legal business name
- AMBROSE HEALTHCARE LLC
- Practice address
- 920 Heritage Park Blvd Ste 120
Layton, UT 84041-5609 - Phone
- (801) 335-6455
- NPI assigned
- Mar 19, 2018
- Last updated
- Mar 19, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Travis Collette
- Title
- VP of Business Development
- Phone
- (208) 360-7668
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 2018-HHA-UT000840 | Primary |
Addresses
Primary practice location
920 Heritage Park Blvd Ste 120
Layton, UT 84041-5609
Mailing address
920 Heritage Park Blvd Ste 120
Layton, UT 84041-5609
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180904001662 | UT | Part A Provider - Home Health Agency | 8527318005 | Practice locations: Bountiful, UT; Orem, UT |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1912401613. Details of each certification follow.
Home health agency certification: CCN 467355
- Legal name
- AMBROSE HEALTHCARE LLC
- Doing business as
- UTAH HOME HEALTH - NORTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Mar 27, 2019
- Last certification
- Mar 27, 2019
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Incorporated
- Jan 22, 2018 in ID
- Enrollment address
- 563 W 500 S
Ste 420
Bountiful, UT 84010-8246
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Utah Home Health - North
- Overall star rating
- Ownership
- Proprietary
- Certified
- Mar 27, 2019
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 46D2147832 | Ambrose Healthcare, LLC | Certificate of waiver | Apr 26, 2028 |
National Provider Directory
National Provider DirectoryLocations
920 Heritage Park Blvd
Ste 130
Layton, UT 84041
Phone (385) 787-5850
358 W Center St
Orem, UT 84057
Phone (801) 373-1400
Ownership & related parties
All disclosed owners & managing parties 9
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Jaimi Ann Willson | 5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 20% |
| Aspen Healthcare Midco Holdings LLC | 5% Or Greater Direct Ownership Interest | Dec 15, 2025 | 100% |
| Aspen Healthcare Holdings LLC | 5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 100% |
| Trevor Collette | 5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 20% |
| The Jeffrey and Jaimi Willson Family Trust | 5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 20% |
| Travis Collette | 5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 20% |
| Derek Paul Collette | 5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 20% |
| Riley Edgington | Contracted Managing Employee | Dec 15, 2025 | 100% |
| Jared Scott Collette | 5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 20% |
Facilities with the same owner 10
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Utah Hospice
- Community Based Hospice Care Agency
- Orem, UT
- NPI 1760705032
Aspen Healthcare Holdings LLC, Aspen Healthcare Midco Holdings LLC, The Jeffrey and Jaimi Willson Family Trust
-
- Home Health Agency
- Provo, UT
- NPI 1811088420
Aspen Healthcare Holdings LLC, Aspen Healthcare Midco Holdings LLC, The Jeffrey and Jaimi Willson Family Trust
-
dba IntegriCare of Eastern Idaho
- Home Health Agency
- Idaho Falls, ID
- NPI 1063568178
Aspen Healthcare Holdings LLC, Aspen Healthcare Midco Holdings LLC, The Jeffrey and Jaimi Willson Family Trust
-
dba Aspen Home Health and Hospice
- Community Based Hospice Care Agency
- Idaho Falls, ID
- NPI 1396891412
Aspen Healthcare Holdings LLC, Aspen Healthcare Midco Holdings LLC, The Jeffrey and Jaimi Willson Family Trust
-
- Community Based Hospice Care Agency
- Mesa, AZ
- NPI 1174144174
Aspen Healthcare Holdings LLC, Aspen Healthcare Midco Holdings LLC, The Jeffrey and Jaimi Willson Family Trust
-
dba Aspen Hospice and Palliative Care
- Community Based Hospice Care Agency
- San Antonio, TX
- NPI 1730478603
Aspen Healthcare Holdings LLC, Aspen Healthcare Midco Holdings LLC, The Jeffrey and Jaimi Willson Family Trust
-
dba San Antonio Home Health
- Home Health Agency
- San Antonio, TX
- NPI 1881835585
Aspen Healthcare Holdings LLC, Aspen Healthcare Midco Holdings LLC, The Jeffrey and Jaimi Willson Family Trust
-
dba Aspen Home Health
- Home Health Agency
- Idaho Falls, ID
- NPI 1083760185
Aspen Healthcare Holdings LLC, Aspen Healthcare Midco Holdings LLC, The Jeffrey and Jaimi Willson Family Trust
-
dba Rexburg Home Health and Hospice
- Home Health Agency
- Rexburg, ID
- NPI 1710033832
Aspen Healthcare Holdings LLC, Aspen Healthcare Midco Holdings LLC, The Jeffrey and Jaimi Willson Family Trust
-
- Home Health Agency
- San Juan Capistrano, CA
- NPI 1720484207
Aspen Healthcare Holdings LLC, Aspen Healthcare Midco Holdings LLC, The Jeffrey and Jaimi Willson Family Trust
Practitioners & affiliated clinicians
Affiliated clinicians 39
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Nurse Practitioner
- Payson, UT
- NPI 1194170860
Home health agency
-
- Family Medicine Physician
- Pleasant Grove, UT
- NPI 1235138751
Home health agency
-
- Medical Physician Assistant
- Orem, UT
- NPI 1821398371
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521417600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1521417600000",
"number": "1912401613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 HERITAGE PARK BLVD STE 120",
"city": "LAYTON",
"state": "UT",
"postal_code": "840415609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 HERITAGE PARK BLVD STE 120",
"city": "LAYTON",
"state": "UT",
"postal_code": "840415609",
"telephone_number": "801-335-6455"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMBROSE HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-03-19",
"last_updated": "2018-03-19",
"status": "A",
"authorized_official_last_name": "COLLETTE",
"authorized_official_first_name": "TRAVIS",
"authorized_official_title_or_position": "VP OF BUSINESS DEVELOPMENT",
"authorized_official_telephone_number": "208-360-7668",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": "2018-HHA-UT000840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Layton, UT
- Alta Meadows Health Care
- Alternative Healing-Trauma and Psychedelic Integration Clinic (Alternative Therapy)
- Brandi Alvarez
- Lizbeth Alvarez
- Heather Amann, MS, CCC-SLP
- Heather Jean Ambrose, PH.D., LMFT, LPC
- American Current Care P.a . (Concentra Urgent Care)
- American Current Care PA (Concentra Urgent Care)
- Grace Amidan
- Brent R Amil, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.