=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578724662
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARING HEARTS HOME HEALTH CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2008
-----------------------------------------------------
Last Update Date | 11/04/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11650 LANTERN RD SUITE 111
-----------------------------------------------------
City | FISHERS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46038-3096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-913-4094
-----------------------------------------------------
Fax | 317-913-4098
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11650 LANTERN RD SUITE 111
-----------------------------------------------------
City | FISHERS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46038-3096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-913-4094
-----------------------------------------------------
Fax | 317-913-4098
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | MR. DANA T. GREENWOOD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 317-913-4094
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------