Provider Demographics
NPI:1275814501
Name:ROSEHEART HOMECARE
Entity Type:Organization
Organization Name:ROSEHEART HOMECARE
Other - Org Name:FIRSTLIGHT HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-901-4585
Mailing Address - Street 1:322 S PATTERSON BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2845
Mailing Address - Country:US
Mailing Address - Phone:937-550-1299
Mailing Address - Fax:614-448-1465
Practice Address - Street 1:322 S PATTERSON BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2845
Practice Address - Country:US
Practice Address - Phone:937-550-1299
Practice Address - Fax:614-448-1465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health