Provider Demographics
NPI:1598894164
Name:HEARTH & HOME ASSISTED LIVING
Entity Type:Organization
Organization Name:HEARTH & HOME ASSISTED LIVING
Other - Org Name:HEARTH & HOME ASSISTED LIVING AT YANDALIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF ASSISTED LIVING DIVISION
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-964-8974
Mailing Address - Street 1:55 GREAT HILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414
Mailing Address - Country:US
Mailing Address - Phone:937-264-1140
Mailing Address - Fax:937-372-0037
Practice Address - Street 1:55 GREAT HILL DRIVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414
Practice Address - Country:US
Practice Address - Phone:937-264-1140
Practice Address - Fax:937-372-0037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility