=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932252020
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME SWEET HOME CARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2007
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16 W 6TH ST
-----------------------------------------------------
City | ATLANTIC
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50022-1449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 712-542-4181
-----------------------------------------------------
Fax | 712-542-2542
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16 W 6TH ST
-----------------------------------------------------
City | ATLANTIC
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50022-1449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 712-542-4181
-----------------------------------------------------
Fax | 712-542-2542
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BRANCH ADMIN.
-----------------------------------------------------
Name | MRS. TISH ANN FRAZIER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 712-542-4181
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------