Provider Demographics
NPI:1801037569
Name:ANGELS OF THE HEART HOSPICE, LLC
Entity Type:Organization
Organization Name:ANGELS OF THE HEART HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CRUMRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-840-4236
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46121-0128
Mailing Address - Country:US
Mailing Address - Phone:317-539-2200
Mailing Address - Fax:317-539-2201
Practice Address - Street 1:8045 W US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46121-9010
Practice Address - Country:US
Practice Address - Phone:317-539-2200
Practice Address - Fax:317-539-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based