MEDICARE: HEARTFELT LEGACY HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747A0650X	Attendant Care Provider
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1063341717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTFELT LEGACY HOMECARE LLC

Provider Business Mailing Address
First Line	:	2005 CAROLINE AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-3538
Country	:	US
Telephone Number	:	317-408-1534
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 CAROLINE AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-3538
Country	:	US
Telephone Number	:	317-408-1534
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHINA KENDRICK
Credential	:
Telephone Number	:	317-408-1534

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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