Healthcare Provider Details

I. General information

NPI: 1326227117
Provider Name (Legal Business Name): HAMMOND CARE FROM THE HEART SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2007
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 CONKEY ST 2ND FLOOR
HAMMOND IN
46324-1100
US

IV. Provider business mailing address

2158 45TH ST PMB - 511
HIGHLAND IN
46322-3742
US

V. Phone/Fax

Practice location:
  • Phone: 291-933-7111
  • Fax: 219-933-6657
Mailing address:
  • Phone: 219-933-7111
  • Fax: 219-933-6657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number28171444A
License Number StateIN

VIII. Authorized Official

Name: MANZELLA MILLER
Title or Position: SECRETARY
Credential:
Phone: 219-933-7111