Hearthside Home Health Agency, Inc
Organization Active NPI Home Health Agency · Salmon, ID
NPI 1922030352 · NPPES record last updated Jul 16, 2010
Key facts
- NPI
- 1922030352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- HH-135 (ID)
- Legal business name
- HEARTHSIDE HOME HEALTH AGENCY, INC
- Practice address
- 1403 Leadore Ave
Salmon, ID 83467-3622 - Phone
- (208) 756-6383
- Fax
- (208) 756-1312
- NPI assigned
- Jul 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Hanna Vermaas, RN/BSN
- Title
- Administator Owner
- Phone
- (209) 756-6383
Practitioners 1
-
Jacob Raymond Bryan, MOTR L
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | HH-135 | ID | Yes |
Addresses
Primary practice location
1403 Leadore Ave
Salmon, ID 83467-3622
Mailing address
1403 Leadore Ave
Salmon, ID 83467-3622
Phone (208) 756-6383
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002703600 | Medicaid | ID |
Other providers in Salmon, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.