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13D2085607 CLIA NUMBER - AVAMERE HOME HEALTH CARE LLC DBA SIGNATURE HEALTHCARE AT HOME

Laboratory Demographics

CLIA Number: 13D2085607

Facility Name: AVAMERE HOME HEALTH CARE LLC DBA SIGNATURE HEALTHCARE AT HOME

Facility Address:
3904 E FLAMINGO STE 100
NAMPA, ID
ZIP 83687
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Facility Phone Number: 208 465-7121

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1841749462

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 13D2085607
LAB Type Home Health Agency
Facility Name AVAMERE HOME HEALTH CARE LLC DBA SIGNATURE HEALTHCARE AT HOME
Street 3904 E FLAMINGO STE 100
City NAMPA
State ID
ZIP 83687
Phone 208 465-7121
CertificateType 4
CertificateEffectiveDate 10/17/2022
CertificateExpirationDate 10/16/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024