Provider Demographics
NPI:1760805725
Name:HEARING HEALTH IN HOME CARE, LLC
Entity Type:Organization
Organization Name:HEARING HEALTH IN HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:RIEDAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-444-6911
Mailing Address - Street 1:19760 MADDELENA CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33967-0537
Mailing Address - Country:US
Mailing Address - Phone:239-444-6911
Mailing Address - Fax:239-444-6911
Practice Address - Street 1:19760 MADDELENA CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33967-0537
Practice Address - Country:US
Practice Address - Phone:239-444-6911
Practice Address - Fax:239-444-6911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4794237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty