Organization
HOSPICE ALLIANCE OF IDAHO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN LARSEN (OWNER/CEO)
(435) 753-0707
Entity
Organization
Contact information
Practice address
1270 S WOODRUFF AVE, IDAHO FALLS, ID 83404-5544
(208) 552-0249
(208) 552-6172
Mailing address
965 S 100 W, SUITE 204, LOGAN, UT 84321-6062
(435) 753-0707
(435) 755-8505
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Enumeration date
08/21/2006
Last updated
08/22/2020
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