MEDICARE: HEARTS OF ANGELS HOME CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1467047662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTS OF ANGELS HOME CARE LLC

Provider Business Mailing Address
First Line	:	25 JONES ST
Second Line	:
City	:	MADISON
State	:	ME
Zip	:	04950-1504
Country	:	US
Telephone Number	:	207-313-9654
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 JONES ST
Second Line	:
City	:	MADISON
State	:	ME
Zip	:	04950-1504
Country	:	US
Telephone Number	:	207-313-9654
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	RHONDA D BISHOP
Credential	:
Telephone Number	:	207-313-9666

Provider Enumeration Date	:	03/09/2021
Last Update Date	:	03/09/2021

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