NPI Code Details Logo

NPI 1790651040

NPI 1790651040 : CAREGIVERS WITH HEART, LLC : STATE COLLEGE, PA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1790651040
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    CAREGIVERS WITH HEART, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/14/2025
-----------------------------------------------------
    Last Update Date     |    10/14/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1402 S ATHERTON ST 
-----------------------------------------------------
    City                 |    STATE COLLEGE
-----------------------------------------------------
    State                |    PA
-----------------------------------------------------
    Zip                  |    16801-6255
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    814-600-9802
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1402 S ATHERTON ST 
-----------------------------------------------------
    City                 |    STATE COLLEGE
-----------------------------------------------------
    State                |    PA
-----------------------------------------------------
    Zip                  |    16801-6255
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    814-600-9802
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER/DIRECTOR
-----------------------------------------------------
    Name                 |     PHILLIP D BOTTENFIELD 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    814-600-9802
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    372600000X
-----------------------------------------------------
    Taxonomy Name        |    Adult Companion
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    374U00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Aide
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    376J00000X
-----------------------------------------------------
    Taxonomy Name        |    Homemaker
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    253Z00000X
-----------------------------------------------------
    Taxonomy Name        |    In Home Supportive Care Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.