Provider Demographics
NPI:1942023213
Name:FOUNTAIN HILLS MEDICAL & HOME HOME HEALTH AGENCY LLC
Entity type:Organization
Organization Name:FOUNTAIN HILLS MEDICAL & HOME HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEMBI
Authorized Official - Middle Name:JUDIS
Authorized Official - Last Name:CHE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ARNP
Authorized Official - Phone:509-780-3155
Mailing Address - Street 1:1705 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-3932
Mailing Address - Country:US
Mailing Address - Phone:208-553-4308
Mailing Address - Fax:
Practice Address - Street 1:1705 11TH ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-3932
Practice Address - Country:US
Practice Address - Phone:208-553-4308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No251E00000XAgenciesHome Health