Provider Demographics
NPI:1346561578
Name:HEART AND SOUL PERSONAL SERVICES AGENCY LLC
Entity Type:Organization
Organization Name:HEART AND SOUL PERSONAL SERVICES AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-575-0960
Mailing Address - Street 1:23737 US HIGHWAY 33
Mailing Address - Street 2:SUITE C1
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-3564
Mailing Address - Country:US
Mailing Address - Phone:574-875-5099
Mailing Address - Fax:574-875-5044
Practice Address - Street 1:23737 US HIGHWAY 33
Practice Address - Street 2:SUITE C1
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46517-3564
Practice Address - Country:US
Practice Address - Phone:574-875-5099
Practice Address - Fax:574-875-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care