Provider Demographics
NPI:1679271316
Name:HOME HEART LLC
Entity Type:Organization
Organization Name:HOME HEART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:502-919-1140
Mailing Address - Street 1:2815 TAYLORSVILLE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2100
Mailing Address - Country:US
Mailing Address - Phone:833-788-4327
Mailing Address - Fax:
Practice Address - Street 1:2815 TAYLORSVILLE RD STE 107
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2100
Practice Address - Country:US
Practice Address - Phone:833-788-4327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine