Provider Demographics
NPI:1154316834
Name:HEARTLAND HOME CARE, LLC
Entity Type:Organization
Organization Name:HEARTLAND HOME CARE, LLC
Other - Org Name:PROMEDICA HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-252-5734
Mailing Address - Street 1:333 N SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:419-252-5734
Mailing Address - Fax:800-480-3780
Practice Address - Street 1:430 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:OH
Practice Address - Zip Code:43410-2142
Practice Address - Country:US
Practice Address - Phone:419-435-1832
Practice Address - Fax:419-435-9511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
OH0164HSP251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH367261Medicare Oscar/Certification
OH367261Medicare Oscar/Certification
OH06074OtherPARAMOUNT HEALTH CARE
MI141087OtherCARE CHOICES
MI141087OtherTRINITY HEALTH PLANS
OH0637494Medicaid