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NPI Code Detail

MEDICARE: HOMEFRONT HOME CARE LLC

MEDICARE: HOMEFRONT HOME CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1700567740
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOMEFRONT HOME CARE LLC
Provider Business Mailing Address
First Line : 6821 LIMA RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46818-1145
Country : US
Telephone Number : 260-704-3922
Fax Number : 260-232-0007
Provider Business Practice Location Address
First Line : 6821 LIMA RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46818-1145
Country : US
Telephone Number : 260-704-3922
Fax Number : 260-232-0007
Authorized Official
Title or Position : OWNER / CEO
Name : MR. DREW DANIEL BOTTERON
Credential : MBA
Telephone Number : 317-801-0390
Provider Enumeration Date : 07/31/2023
Last Update Date : 04/09/2026

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Directions to “HOMEFRONT HOME CARE LLC ” Practice Location

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