Healthcare Provider Details

I. General information

NPI: 1336194356
Provider Name (Legal Business Name): IN HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4487 COLUMBIA RD STE 103
MARTINEZ GA
30907-4255
US

IV. Provider business mailing address

333 N. SUMMIT ST. ATTN: LEGAL DEPARTMENT
TOLEDO OH
43604-2615
US

V. Phone/Fax

Practice location:
  • Phone: 706-860-7374
  • Fax: 706-860-9410
Mailing address:
  • Phone: 419-252-5500
  • Fax: 877-385-9446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

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