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General NPI Number Information
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NPI Number | 1710694724
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Entity Type | Organization
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Legal Business Name | HEART GLOW SERVICES LLC
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 5661 VALHALLA WAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46235-6027
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Country | US
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Telephone | 916-613-6499
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Fax |
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Provider Business Mailing Address
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Address Line | 5661 VALHALLA WAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46235-6027
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Country | US
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Telephone | 317-797-2011
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | UJUNWA UCHENDU
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Credential | CAN, QMA, HIM
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Telephone | 317-797-2011
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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 |
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License Number State |
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Taxonomy #2
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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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