Provider Demographics
NPI:1003251307
Name:HEART 'N HOME HOSPICE AND PALLIATIVE CARE, LLC
Entity Type:Organization
Organization Name:HEART 'N HOME HOSPICE AND PALLIATIVE CARE, LLC
Other - Org Name:HEART 'N HOME HOSPICE & PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GACHASSIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-233-1307
Mailing Address - Street 1:1100 NW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND
Mailing Address - State:ID
Mailing Address - Zip Code:83619-5040
Mailing Address - Country:US
Mailing Address - Phone:208-452-2662
Mailing Address - Fax:208-452-2675
Practice Address - Street 1:51681 HUNTINGTON RD
Practice Address - Street 2:
Practice Address - City:LA PINE
Practice Address - State:OR
Practice Address - Zip Code:97739-9626
Practice Address - Country:US
Practice Address - Phone:541-536-7399
Practice Address - Fax:541-536-9312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORDMAP-139209Medicaid