Provider Demographics
NPI:1891064309
Name:CARING HEARTS AT HOME, LLC
Entity Type:Organization
Organization Name:CARING HEARTS AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-592-9906
Mailing Address - Street 1:2000 BALSAM LN
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MN
Mailing Address - Zip Code:55373-4587
Mailing Address - Country:US
Mailing Address - Phone:651-592-9906
Mailing Address - Fax:
Practice Address - Street 1:2000 BALSAM LN
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MN
Practice Address - Zip Code:55373-4587
Practice Address - Country:US
Practice Address - Phone:651-592-9906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3991028-2251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health