Healthcare Provider Details

I. General information

NPI: 1639930555
Provider Name (Legal Business Name): COMPASSIONATES HEARTS HOLISTIC CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 01/18/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5435 EMERSON WAY
INDIANAPOLIS IN
46226-1466
US

IV. Provider business mailing address

3361 N ALTON AVE APT A
INDIANAPOLIS IN
46222-1873
US

V. Phone/Fax

Practice location:
  • Phone: 317-446-0643
  • Fax:
Mailing address:
  • Phone: 317-446-0643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN HAWKINS
Title or Position: OWNER
Credential: LPN
Phone: 317-446-0643