MEDICARE: CARE FROM THE HEART 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

General Provider Information

NPI Number	:	1417563248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE FROM THE HEART LLC

Provider Business Mailing Address
First Line	:	3335 STANLEY AVE STE B
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45404-2005
Country	:	US
Telephone Number	:	937-701-0135
Fax Number	:

Provider Business Practice Location Address
First Line	:	3335 STANLEY AVE STE B
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45404-2005
Country	:	US
Telephone Number	:	937-701-0135
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KELLEY MITCHELL
Credential	:
Telephone Number	:	937-701-0135

Provider Enumeration Date	:	09/17/2020
Last Update Date	:	09/17/2020

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Directions to “CARE FROM THE HEART LLC ” Practice Location

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