Healthcare Provider Details

I. General information

NPI: 1194744664
Provider Name (Legal Business Name): ADVENTHEALTH HOME HEALTH AND HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 MEMORIAL DR STE 2
MANCHESTER KY
40962-6196
US

IV. Provider business mailing address

210 MARIE LANGDON DR
MANCHESTER KY
40962-6388
US

V. Phone/Fax

Practice location:
  • Phone: 606-598-1969
  • Fax:
Mailing address:
  • Phone: 606-598-1969
  • Fax: 606-598-2062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number150039
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MARK WHEELER
Title or Position: CFO
Credential:
Phone: 530-545-1409