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General NPI Number Information
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NPI Number | 1114564861
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Entity Type | Organization
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Legal Business Name | HADLEY HOME CARE LLC
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Dates
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Enumeration Date | 12/02/2019
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Last Update Date | 12/02/2019
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Provider Practice Location Address
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Address Line | 414 W STOCKTON ST
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City | EDMONTON
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State | KY
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Zip | 42129-9435
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Country | US
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Telephone | 270-590-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4
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City | EDMONTON
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State | KY
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Zip | 42129-0004
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Country | US
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Telephone | 270-590-2000
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MS. LISA DAWN GEARLDS
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Credential |
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Telephone | 270-590-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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