Healthcare Provider Details

I. General information

NPI: 1053662601
Provider Name (Legal Business Name): HOMEFORHEROES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2012
Last Update Date: 09/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 SUMMER ST SW
HUNTSVILLE AL
35805-3816
US

IV. Provider business mailing address

283 BURWELL RD
HARVEST AL
35749-9166
US

V. Phone/Fax

Practice location:
  • Phone: 256-426-0130
  • Fax:
Mailing address:
  • Phone: 256-426-0130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. MERVICE MECHELLE TOWNSEND
Title or Position: CEO
Credential:
Phone: 256-426-0130