Healthcare Provider Details

I. General information

NPI: 1063464428
Provider Name (Legal Business Name): IN HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 CHAPMAN RD STE 102
NEWARK DE
19702-5417
US

IV. Provider business mailing address

333 N SUMMIT ST LICENSURE-SUPPORT
TOLEDO OH
43604-2615
US

V. Phone/Fax

Practice location:
  • Phone: 302-455-1500
  • Fax: 302-455-1504
Mailing address:
  • Phone: 419-252-5500
  • Fax: 877-385-9446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHAS-009
License Number StateDE

VIII. Authorized Official

Name: MR. MARTIN D ALLEN
Title or Position: DIRECTOR
Credential:
Phone: 419-252-5734