Provider Demographics
NPI:1346513298
Name:FORTE HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:FORTE HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-528-6398
Mailing Address - Street 1:120 S LAKE ST
Mailing Address - Street 2:STE 50
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-2850
Mailing Address - Country:US
Mailing Address - Phone:574-528-6398
Mailing Address - Fax:866-757-6066
Practice Address - Street 1:120 S LAKE ST
Practice Address - Street 2:STE 50
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-2850
Practice Address - Country:US
Practice Address - Phone:574-528-6398
Practice Address - Fax:866-757-6066
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FORTE RESIDENTIAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-22
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN012779251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN012779OtherINDIANA STATE DEPARTMENT OF HEALTH