Provider Demographics
NPI:1124562806
Name:HOME HEALTHCARE HEROES LLC
Entity Type:Organization
Organization Name:HOME HEALTHCARE HEROES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:KAKASULEFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-298-8234
Mailing Address - Street 1:3310 MAIN ST
Mailing Address - Street 2:SUITE E1
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46013-4264
Mailing Address - Country:US
Mailing Address - Phone:765-298-8234
Mailing Address - Fax:765-400-5327
Practice Address - Street 1:3310 MAIN ST
Practice Address - Street 2:SUITE E1
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-4264
Practice Address - Country:US
Practice Address - Phone:765-298-8234
Practice Address - Fax:765-400-5327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN160139971251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health