Provider Demographics
NPI:1013316496
Name:HOMECARE WITH HEART SERVICES, LLC
Entity type:Organization
Organization Name:HOMECARE WITH HEART SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF NURSING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-970-1189
Mailing Address - Street 1:821 KENTWOOD DR STE B
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5061
Mailing Address - Country:US
Mailing Address - Phone:330-726-0700
Mailing Address - Fax:330-726-0704
Practice Address - Street 1:821 KENTWOOD DR STE B
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-5061
Practice Address - Country:US
Practice Address - Phone:330-726-0700
Practice Address - Fax:330-726-0704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0197357Medicaid