Organization
TETON HOME HEALTH, LLC
Active
Other names
AVALON HOME HEALTH, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAKE BRYAN M.O.T. (MANAGER/OWNER)
(435) 730-5860
Entity
Organization
Contact information
Practice address
403 1ST ST, IDAHO FALLS, ID 83401-3928
(208) 419-0896
(208) 419-0974
Mailing address
403 1ST ST, IDAHO FALLS, ID 83401-3928
(208) 419-0896
(208) 419-0974
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
APPLIED FOR
ID
Other
Enumeration date
07/20/2010
Last updated
08/12/2011
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