Provider Demographics
NPI:1235849464
Name:HERITAGE HOME HEALTH SERVICES OF INDIANA LLC
Entity Type:Organization
Organization Name:HERITAGE HOME HEALTH SERVICES OF INDIANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:PRYOR
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:765-482-6680
Mailing Address - Street 1:7750 PARAGON RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4050
Mailing Address - Country:US
Mailing Address - Phone:937-291-3780
Mailing Address - Fax:937-291-3789
Practice Address - Street 1:1102 S LEBANON ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-2717
Practice Address - Country:US
Practice Address - Phone:765-482-6680
Practice Address - Fax:765-482-6690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health