Provider Demographics
NPI:1942714340
Name:HOME SWEET HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:HOME SWEET HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:260-316-7669
Mailing Address - Street 1:1220 S WAYNE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46703-6952
Mailing Address - Country:US
Mailing Address - Phone:260-316-8281
Mailing Address - Fax:260-668-7668
Practice Address - Street 1:1220 S WAYNE ST STE 3
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-6952
Practice Address - Country:US
Practice Address - Phone:260-316-8281
Practice Address - Fax:260-668-7668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17-014208-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health