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General NPI Number Information
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NPI Number | 1174310940
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Entity Type | Organization
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Legal Business Name | HEARTS AT HOME LLC
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 418 E LAKESIDE AVE STE 6
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2805
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Country | US
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Telephone | 208-600-0760
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Fax |
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Provider Business Mailing Address
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Address Line | 418 E LAKESIDE AVE STE 6
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2805
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Country | US
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Telephone | 208-600-0760
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DOUGLAS D HOLCOMB
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Credential | RN
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Telephone | 360-536-5432
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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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