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General NPI Number Information
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NPI Number | 1659300853
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Entity Type | Organization
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Legal Business Name | HEARTLAND HOME CARE LLC
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2802 N KICKAPOO AVE
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City | SHAWNEE
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State | OK
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Zip | 74804-1798
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Country | US
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Telephone | 405-214-6441
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Fax | 405-214-6404
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Provider Business Mailing Address
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Address Line | 333 N SUMMIT ST ATTN: DEAN SHIPMAN
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City | TOLEDO
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State | OH
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Zip | 43604-1531
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Country | US
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Telephone | 419-254-7841
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Fax | 419-252-6448
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MARTIN D ALLEN
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Credential |
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Telephone | 419-252-5734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7163
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License Number State | OK
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