Provider Demographics
NPI:1366494502
Name:IN HOME HEALTH LLC
Entity Type:Organization
Organization Name:IN HOME HEALTH LLC
Other - Org Name:HEARTLAND HOME HEALTH CARE AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT - REIMBURSEMENTS
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAZARUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-252-5541
Mailing Address - Street 1:333 N SUMMIT ST
Mailing Address - Street 2:ATTN DEAN SHIPMAN
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:419-254-7841
Mailing Address - Fax:419-252-6448
Practice Address - Street 1:901 SUNVALLEY BLVD
Practice Address - Street 2:SUITE 220B
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5899
Practice Address - Country:US
Practice Address - Phone:925-674-8610
Practice Address - Fax:925-825-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2009-11-30
Deactivation Date:2006-08-15
Deactivation Code:
Reactivation Date:2009-07-24
Provider Licenses
StateLicense IDTaxonomies
CA070000572251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC016835Medicaid
CA051686Medicare Oscar/Certification