Provider Demographics
NPI:1366867319
Name:CARE IN THE HEART OF HOME
Entity Type:Organization
Organization Name:CARE IN THE HEART OF HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOMEMAKER SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:STAUFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-409-1607
Mailing Address - Street 1:614 E SEMINARY ST
Mailing Address - Street 2:
Mailing Address - City:BUNKER HILL
Mailing Address - State:IL
Mailing Address - Zip Code:62014-1208
Mailing Address - Country:US
Mailing Address - Phone:618-409-1607
Mailing Address - Fax:
Practice Address - Street 1:614 E SEMINARY ST
Practice Address - Street 2:
Practice Address - City:BUNKER HILL
Practice Address - State:IL
Practice Address - Zip Code:62014-1208
Practice Address - Country:US
Practice Address - Phone:618-406-1607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization