Provider Demographics
NPI:1942690904
Name:SERVANT HEART HELPERS, INC.
Entity Type:Organization
Organization Name:SERVANT HEART HELPERS, INC.
Other - Org Name:HOME HELPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:LUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-692-2074
Mailing Address - Street 1:111 S FARMER ST
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MI
Mailing Address - Zip Code:49078-1119
Mailing Address - Country:US
Mailing Address - Phone:269-692-2074
Mailing Address - Fax:775-514-8859
Practice Address - Street 1:111 S FARMER ST
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MI
Practice Address - Zip Code:49078-1119
Practice Address - Country:US
Practice Address - Phone:269-692-2074
Practice Address - Fax:775-514-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI45490C253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8779373OtherDEPARTMENT OF HUMAN SERVICES - CHORE PROVIDER SERVICES