Provider Demographics
NPI:1174562532
Name:HAMMOND CARE FROM THE HEART SOCIAL SERVICES, LLC.
Entity type:Organization
Organization Name:HAMMOND CARE FROM THE HEART SOCIAL SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-933-7111
Mailing Address - Street 1:534 CONKEY ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-1100
Mailing Address - Country:US
Mailing Address - Phone:219-933-7111
Mailing Address - Fax:219-933-6657
Practice Address - Street 1:534 CONKEY ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-1100
Practice Address - Country:US
Practice Address - Phone:219-933-7111
Practice Address - Fax:219-933-6657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01194049310012251B00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200440490AOtherPROVIDER NUMBER
IN200440490AOtherPROVIDER NUMBER