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General NPI Number Information
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NPI Number | 1568947729
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Entity Type | Organization
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Legal Business Name | HEART AT HOME, LLC
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 10/03/2018
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Provider Practice Location Address
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Address Line | 53211 KINGLET LN
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City | SOUTH BEND
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State | IN
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Zip | 46637-5112
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Country | US
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Telephone | 574-213-8616
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4022
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City | SOUTH BEND
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State | IN
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Zip | 46634-4022
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Country | US
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Telephone | 574-213-8616
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | DENICKA FOSTER
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Credential |
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Telephone | 574-213-8616
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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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