=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932521879
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOMETOWN HOME HEALTHCARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2014
-----------------------------------------------------
Last Update Date | 11/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 302 E NORTH B ST
-----------------------------------------------------
City | GAS CITY
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46933-1440
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-674-7177
-----------------------------------------------------
Fax | 765-674-7179
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 302 E NORTH B ST
-----------------------------------------------------
City | GAS CITY
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46933-1440
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-674-7177
-----------------------------------------------------
Fax | 765-674-7179
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ADMINISTRATOR
-----------------------------------------------------
Name | MITCHELL EUGENE WEAVER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 765-674-7177
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 130133491
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------