Provider Demographics
NPI:1164232286
Name:HOMECARE ALLIES LLC
Entity type:Organization
Organization Name:HOMECARE ALLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAXSON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DUFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-715-0535
Mailing Address - Street 1:886 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-4030
Mailing Address - Country:US
Mailing Address - Phone:208-715-0535
Mailing Address - Fax:
Practice Address - Street 1:886 MAPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-4030
Practice Address - Country:US
Practice Address - Phone:208-715-0535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility