Organization
ADDUS HEALTHCARE (IDAHO), INC
Active
Other names
Addus HomeCare
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE KUMARICH RN, MS, MBA (NATIONAL CONTRACTS)
(630) 296-3400
Entity
Organization
Contact information
Practice address
1037A 21ST ST, LEWISTON, ID 83501-3415
(208) 746-8881
(855) 808-6973
Mailing address
2300 WARRENVILLE RD, SUITE 100, DOWNERS GROVE, IL 60515-1765
(630) 296-3400
(630) 487-2713
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
807562000
LEWISTON - DDA
ID
Enumeration date
05/01/2007
Last updated
06/17/2015
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