MEDICARE: HAZE HOMECARE

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	:	1780316067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAZE HOMECARE

Provider Business Mailing Address
First Line	:	116 SUNSET LN
Second Line	:
City	:	ELK RUN HEIGHTS
State	:	IA
Zip	:	50707-1373
Country	:	US
Telephone Number	:	319-299-4609
Fax Number	:	319-333-7099

Provider Business Practice Location Address
First Line	:	116 SUNSET LN
Second Line	:
City	:	ELK RUN HEIGHTS
State	:	IA
Zip	:	50707-1373
Country	:	US
Telephone Number	:	319-299-4609
Fax Number	:	319-333-7099

Authorized Official
Title or Position	:	OWNER
Name	:	LYNETTE HAYES
Credential	:	RN
Telephone Number	:	319-239-2039

Provider Enumeration Date	:	06/27/2022
Last Update Date	:	06/27/2022

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Directions to “HAZE HOMECARE ” Practice Location

Language	Start Address	Practice Location

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