Provider Demographics
NPI:1902179864
Name:HOME IS THE HEART HOMECARE AGENCY
Entity Type:Organization
Organization Name:HOME IS THE HEART HOMECARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSTICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-489-5873
Mailing Address - Street 1:316 MURRAY FORK DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-0914
Mailing Address - Country:US
Mailing Address - Phone:910-489-5873
Mailing Address - Fax:910-822-3549
Practice Address - Street 1:316 MURRAY FORK DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-0914
Practice Address - Country:US
Practice Address - Phone:910-489-5873
Practice Address - Fax:910-822-3549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4526251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health