Provider Demographics
NPI:1295404416
Name:WHOLE HEART HOMECARE LLC
Entity Type:Organization
Organization Name:WHOLE HEART HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-464-5324
Mailing Address - Street 1:28 CHAMBERLAIN AVE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:MA
Mailing Address - Zip Code:01226-1803
Mailing Address - Country:US
Mailing Address - Phone:413-464-5364
Mailing Address - Fax:
Practice Address - Street 1:28 CHAMBERLAIN AVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:MA
Practice Address - Zip Code:01226-1803
Practice Address - Country:US
Practice Address - Phone:413-464-5364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care