Provider Demographics
NPI:1689455511
Name:HEART AT HOME CARE OF MIDWEST LLC
Entity Type:Organization
Organization Name:HEART AT HOME CARE OF MIDWEST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AFZAL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-771-7792
Mailing Address - Street 1:3436 RIDGE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-3154
Mailing Address - Country:US
Mailing Address - Phone:219-771-7792
Mailing Address - Fax:219-769-7032
Practice Address - Street 1:3436 RIDGE RD STE 3
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-3154
Practice Address - Country:US
Practice Address - Phone:219-771-7792
Practice Address - Fax:219-769-7032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health