1174060644 NPI number — CARING HEARTS HOME HEALTH LLC.

Table of content: (NPI 1174060644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174060644 NPI number — CARING HEARTS HOME HEALTH LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARING HEARTS HOME HEALTH LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174060644
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
314 S HIGH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CALIFORNIA
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65018-1808
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-789-8498
Provider Business Mailing Address Fax Number:
636-600-5079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
314 S HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CALIFORNIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65018-1808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-789-8498
Provider Business Practice Location Address Fax Number:
636-600-5079
Provider Enumeration Date:
01/23/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LEWIS
Authorized Official First Name:
SAMANTHA
Authorized Official Middle Name:
LEIGH
Authorized Official Title or Position:
OWNER / OFFICE MANAGER
Authorized Official Telephone Number:
573-789-8498

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)