Provider Demographics
NPI:1932104247
Name:HEART TO HEART HOSPICE OF CENTRAL INDIANA, LLC
Entity Type:Organization
Organization Name:HEART TO HEART HOSPICE OF CENTRAL INDIANA, LLC
Other - Org Name:NEW HOPE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:O
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-517-6300
Mailing Address - Street 1:7240 CHASE OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5901
Mailing Address - Country:US
Mailing Address - Phone:972-517-6300
Mailing Address - Fax:972-517-2014
Practice Address - Street 1:1385 N BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-1913
Practice Address - Country:US
Practice Address - Phone:765-770-0684
Practice Address - Fax:765-677-0689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05-003966-1251G00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200492790Medicaid
IN200492790Medicaid