Provider Demographics
NPI:1750120770
Name:FRIENDLY HEARTS HOME HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:FRIENDLY HEARTS HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:TAQUITA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:317-279-6262
Mailing Address - Street 1:2516 WIGEON CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46234-8800
Mailing Address - Country:US
Mailing Address - Phone:317-279-6262
Mailing Address - Fax:317-992-2966
Practice Address - Street 1:3500 DEPAUW BLVD
Practice Address - Street 2:SUITE 10806
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1170
Practice Address - Country:US
Practice Address - Phone:317-279-6262
Practice Address - Fax:317-992-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty