Healthcare Provider Details

I. General information

NPI: 1013844174
Provider Name (Legal Business Name): HEARTLAND HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HARDWOOD LN
FAIRFIELD ME
04937-3206
US

IV. Provider business mailing address

16 HARDWOOD LN
FAIRFIELD ME
04937-3206
US

V. Phone/Fax

Practice location:
  • Phone: 207-215-1222
  • Fax:
Mailing address:
  • Phone: 207-215-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: PRUDENCE ANN BURGESS
Title or Position: OWNER
Credential: RN
Phone: 207-215-1222