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General NPI Number Information
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NPI Number | 1720528094
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Entity Type | Organization
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Legal Business Name | FIREFLY HOME HEALTH LLC
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 100 SOUTH MAIN STREET
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City | MIDDLEBURY
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State | IN
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Zip | 46540-9083
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Country | US
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Telephone | 574-830-6121
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4
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City | MIDDLEBURY
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State | IN
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Zip | 46540-0004
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMY MANIFOLD
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Credential |
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Telephone | 574-830-6121
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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 | IN
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