Provider Demographics
NPI:1659646479
Name:ANGIE'S HEART HHC
Entity type:Organization
Organization Name:ANGIE'S HEART HHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OTTE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:513-678-0847
Mailing Address - Street 1:3672 SPRINGDALE ROAD (REAR UPPER LEVEL)
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251
Mailing Address - Country:US
Mailing Address - Phone:513-678-0847
Mailing Address - Fax:513-741-7856
Practice Address - Street 1:3672 SPRINGDALE RD REAR UPPER
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-1407
Practice Address - Country:US
Practice Address - Phone:513-678-0847
Practice Address - Fax:513-741-7856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36-8453OtherPTAN OR CCN