Provider Demographics
NPI:1215554837
Name:ENCHANTED HEARTS HOME CARE LLC
Entity Type:Organization
Organization Name:ENCHANTED HEARTS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHAWNDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:317-373-8464
Mailing Address - Street 1:7464 MERRICK DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-5636
Mailing Address - Country:US
Mailing Address - Phone:317-373-8464
Mailing Address - Fax:
Practice Address - Street 1:7464 MERRICK DR
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-5636
Practice Address - Country:US
Practice Address - Phone:317-373-8464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care