Basic Information
| Provider Information | |||||||||
| NPI: | 1821427741 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACHS HOSPICE & PALLIATIVE CARE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 815 S BRIDGE WAY PL | ||||||||
| Address2: | SUITE 122 | ||||||||
| City: | EAGLE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836166006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2084732717 | ||||||||
| FaxNumber: | 8778905617 | ||||||||
| Practice Location | |||||||||
| Address1: | 815 S BRIDGE WAY PL | ||||||||
| Address2: | SUITE 122 | ||||||||
| City: | EAGLE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836166006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2084732717 | ||||||||
| FaxNumber: | 8778905617 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2013 | ||||||||
| LastUpdateDate: | 11/18/2021 | ||||||||
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| AuthorizedOfficialLastName: | HILLESHEIM | ||||||||
| AuthorizedOfficialFirstName: | ANGELA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2084732717 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
| NPICertificationDate: | 11/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | Y | Agencies | Hospice Care, Community Based |
No ID Information.