Provider Demographics
NPI:1124572128
Name:HEALING HANDS HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:HEALING HANDS HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AYOWALE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAO
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:219-853-1309
Mailing Address - Street 1:200 RUSSELL ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46320-1815
Mailing Address - Country:US
Mailing Address - Phone:219-853-1309
Mailing Address - Fax:219-964-4388
Practice Address - Street 1:200 RUSSELL ST
Practice Address - Street 2:SUITE 304
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320-1815
Practice Address - Country:US
Practice Address - Phone:219-853-1309
Practice Address - Fax:219-964-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN15-013730-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health