Provider Demographics
NPI:1902651722
Name:CAREGIVING IN HOME LLC.
Entity Type:Organization
Organization Name:CAREGIVING IN HOME LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CAREGIVER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PTACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-791-4272
Mailing Address - Street 1:1247 FOREST ROAD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:ID
Mailing Address - Zip Code:83555-5009
Mailing Address - Country:US
Mailing Address - Phone:208-924-9860
Mailing Address - Fax:
Practice Address - Street 1:1247 FOREST ROAD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:ID
Practice Address - Zip Code:83555-5009
Practice Address - Country:US
Practice Address - Phone:208-924-9860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care