Provider Demographics
NPI:1114564861
Name:HADLEY HOME CARE LLC
Entity Type:Organization
Organization Name:HADLEY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:GEARLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-590-2000
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:EDMONTON
Mailing Address - State:KY
Mailing Address - Zip Code:42129-0004
Mailing Address - Country:US
Mailing Address - Phone:270-590-2000
Mailing Address - Fax:
Practice Address - Street 1:414 W STOCKTON ST
Practice Address - Street 2:
Practice Address - City:EDMONTON
Practice Address - State:KY
Practice Address - Zip Code:42129-9435
Practice Address - Country:US
Practice Address - Phone:270-590-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care