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General NPI Number Information
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NPI Number | 1992565782
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Entity Type | Organization
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Legal Business Name | SPIRIT OF THE HEART HOME CARE LLC
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Dates
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Enumeration Date | 03/20/2024
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 1624A 210TH ST
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City | SAINT CROIX FALLS
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State | WI
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Zip | 54024-8002
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Country | US
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Telephone | 715-441-0159
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Fax |
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Provider Business Mailing Address
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Address Line | 1624A 210TH ST
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City | SAINT CROIX FALLS
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State | WI
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Zip | 54024-8002
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Country | US
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Telephone | 715-441-0159
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LONNIE JEAN STOWELL
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Credential |
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Telephone | 715-441-0159
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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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