Healthcare Provider Details

I. General information

NPI: 1598702292
Provider Name (Legal Business Name): HERITAGE HOME HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 S EMERSON AVE STE 220
GREENWOOD IN
46143-1952
US

IV. Provider business mailing address

7750 PARAGON RD
DAYTON OH
45459-4050
US

V. Phone/Fax

Practice location:
  • Phone: 317-536-2290
  • Fax: 765-342-8377
Mailing address:
  • Phone: 937-291-3780
  • Fax: 765-342-8377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number05-005294-2
License Number StateIN

VIII. Authorized Official

Name: TAMMY TURNMIRE
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 937-291-3780