Provider Demographics
NPI:1245797612
Name:ALL HEART IN-HOME CARE LLC
Entity type:Organization
Organization Name:ALL HEART IN-HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AREA DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKAVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-353-7130
Mailing Address - Street 1:26702 CALLE ALCALA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2617
Mailing Address - Country:US
Mailing Address - Phone:949-353-7130
Mailing Address - Fax:
Practice Address - Street 1:26702 CALLE ALCALA
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2617
Practice Address - Country:US
Practice Address - Phone:949-353-7130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care