Provider Demographics
NPI:1821414392
Name:HEART FOR HOME LLC
Entity Type:Organization
Organization Name:HEART FOR HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WALCK
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:717-218-7122
Mailing Address - Street 1:301 STONE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-8397
Mailing Address - Country:US
Mailing Address - Phone:717-218-7122
Mailing Address - Fax:
Practice Address - Street 1:301 STONE CHURCH RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-8397
Practice Address - Country:US
Practice Address - Phone:717-218-7122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-08
Last Update Date:2014-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA25003601251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care