Healthcare Provider Details

I. General information

NPI: 1205657459
Provider Name (Legal Business Name): HEARTS OF CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 10/21/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2917 W 20TH AVE
GARY IN
46404-2657
US

IV. Provider business mailing address

2917 W 20TH AVE
GARY IN
46404-2657
US

V. Phone/Fax

Practice location:
  • Phone: 219-678-4818
  • Fax:
Mailing address:
  • Phone: 219-678-4818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: DANA LYNN HOUSTON
Title or Position: DIRECTOR
Credential: BA
Phone: 219-678-4818