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General NPI Number Information
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NPI Number | 1912719196
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Entity Type | Organization
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Legal Business Name | ENCHANTED HEARTS HOME CARE
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 11414 W PARK PL
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City | MILWAUKEE
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State | WI
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Zip | 53224-3500
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Country | US
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Telephone | 414-296-8008
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Fax | 414-296-0107
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Provider Business Mailing Address
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Address Line | 7464 MERRICK DR
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City | BROWNSBURG
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State | IN
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Zip | 46112-5636
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Country | US
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Telephone | 317-373-8464
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAWNDRA TAYLOR
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Credential |
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Telephone | 317-373-8464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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