Provider Demographics
NPI:1922832047
Name:HARMONY RESIDENTIAL CARE IDAHO
Entity type:Organization
Organization Name:HARMONY RESIDENTIAL CARE IDAHO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:KOFI
Authorized Official - Middle Name:
Authorized Official - Last Name:FORSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-268-1596
Mailing Address - Street 1:800 4TH AVE # 2024
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-2041
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4210 N ALESTER AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-6863
Practice Address - Country:US
Practice Address - Phone:325-268-1596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care