Healthcare Provider Details

I. General information

NPI: 1083751002
Provider Name (Legal Business Name): VISITING NURSE AND HOSPICE HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 HOMESTEAD RD
FORT WAYNE IN
46814-4202
US

IV. Provider business mailing address

5910 HOMESTEAD RD
FORT WAYNE IN
46814-4202
US

V. Phone/Fax

Practice location:
  • Phone: 260-435-3222
  • Fax: 260-435-3275
Mailing address:
  • Phone: 260-435-3222
  • Fax: 260-435-3275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateIN

VIII. Authorized Official

Name: LESLIE FRIEDEL
Title or Position: CEO
Credential:
Phone: 260-435-3222