MEDICARE: HEARTS OF PASSION HHC 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	251E00000X	Home Health Agency
2	163WH0200X	Home Health Registered Nurse

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0337313	OTHER	OH	NON-MEDICAL HOME HEALTH CARE

General Provider Information

NPI Number	:	1194316828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTS OF PASSION HHC LLC

Provider Business Mailing Address
First Line	:	4964 SPRINGBORO PIKE
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-1940
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4964 SPRINGBORO PIKE
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-1940
Country	:	US
Telephone Number	:	937-949-8716
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHEVELLE PASSION BENNETT
Credential	:
Telephone Number	:	937-542-0785

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	01/26/2021

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Directions to “HEARTS OF PASSION HHC LLC ” Practice Location

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