Organization
ALLIANCE HOME HEALTH OF IDAHO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN L. LARSEN (OWNER, CEO)
(435) 753-3133
Entity
Organization
Contact information
Practice address
353 N 4TH AVE, SUITE 205, POCATELLO, ID 83201-6390
(208) 478-2291
(208) 478-1363
Mailing address
353 N 4TH AVE, SUITE 205, POCATELLO, ID 83201-6390
(208) 478-2291
(208) 478-1363
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/21/2006
Last updated
08/22/2020
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