Provider Demographics
NPI:1407888381
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:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-252-5734
Mailing Address - Street 1:PO BOX 10086
Mailing Address - Street 2:LICENSURE-SUPPORT
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43699-0086
Mailing Address - Country:US
Mailing Address - Phone:419-252-5500
Mailing Address - Fax:877-385-9446
Practice Address - Street 1:N6650 ROLLING MEADOWS DR STE 1
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54937-9471
Practice Address - Country:US
Practice Address - Phone:920-926-1144
Practice Address - Fax:920-906-9036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2014251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43190700Medicaid
WI521579Medicare Oscar/Certification