Provider Demographics
NPI:1174258321
Name:CHANGING HEARTS HOME CARE, LLC
Entity Type:Organization
Organization Name:CHANGING HEARTS HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MSHM
Authorized Official - Phone:317-746-6676
Mailing Address - Street 1:916 N SHADELAND AVE STE E
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4825
Mailing Address - Country:US
Mailing Address - Phone:317-746-6676
Mailing Address - Fax:317-956-5810
Practice Address - Street 1:916 N SHADELAND AVE STE E
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4825
Practice Address - Country:US
Practice Address - Phone:317-746-6676
Practice Address - Fax:317-956-5810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No347C00000XTransportation ServicesPrivate Vehicle
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty