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General NPI Number Information
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NPI Number | 1205623261
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Entity Type | Organization
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Legal Business Name | HEART AT HOME
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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 | 29 MADISON AVE
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City | VIENNA
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State | WV
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Zip | 26105-8085
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Country | US
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Telephone | 304-494-1742
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Fax |
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Provider Business Mailing Address
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Address Line | 29 MADISON AVE
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City | VIENNA
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State | WV
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Zip | 26105-8085
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Country | US
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Telephone | 44-941-7142
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | APRIL VANCAMP
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Credential |
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Telephone | 304-481-2935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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