Healthcare Provider Details

I. General information

NPI: 1811356116
Provider Name (Legal Business Name): CARING HEARTS ADULT DAY SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3391 AIRPORT RD
PORTAGE IN
46368-5105
US

IV. Provider business mailing address

3391 AIRPORT RD
PORTAGE IN
46368-5105
US

V. Phone/Fax

Practice location:
  • Phone: 219-841-5787
  • Fax: 219-462-4600
Mailing address:
  • Phone: 219-841-5787
  • Fax: 219-462-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIC MOLDENHAUER
Title or Position: OWNER
Credential:
Phone: 219-841-5787