Organization
GEM HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAX LONG (CEO / ADMINISTRATOR)
(208) 365-3561
Entity
Organization
Contact information
Practice address
1024 E LOCUST ST, EMMETT, ID 83617-2776
(208) 365-3561
(208) 365-4176
Mailing address
1202 E LOCUST ST, EMMETT, ID 83617-2715
(208) 365-3561
(208) 365-4176
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HH130
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010014860
REGENCE BLUE SHIELD
ID
01
—
01818
BLUE CROSS
ID
Enumeration date
07/20/2005
Last updated
08/22/2020
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