Healthcare Provider Details

I. General information

NPI: 1912829003
Provider Name (Legal Business Name): GLORIA'S HEART HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3526 STELLHORN RD
FORT WAYNE IN
46815-8661
US

IV. Provider business mailing address

3526 STELLHORN RD
FORT WAYNE IN
46815-8661
US

V. Phone/Fax

Practice location:
  • Phone: 260-750-5123
  • Fax: 260-298-7486
Mailing address:
  • Phone: 260-750-5123
  • Fax: 260-298-7486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SHIRLEY ANN MALONE
Title or Position: CEO / OWNER
Credential:
Phone: 260-750-5123