Provider Demographics
NPI:1215195359
Name:HOLIDAY HOME HEALTH CARE CORP OF EVANSVILLE
Entity Type:Organization
Organization Name:HOLIDAY HOME HEALTH CARE CORP OF EVANSVILLE
Other - Org Name:HERITAGE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-429-0700
Mailing Address - Street 1:1201 W BUENA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-3336
Mailing Address - Country:US
Mailing Address - Phone:812-429-0700
Mailing Address - Fax:812-429-1849
Practice Address - Street 1:1201 W BUENA VISTA RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-3336
Practice Address - Country:US
Practice Address - Phone:812-429-0700
Practice Address - Fax:812-429-1849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000097897OtherANTHEM