Provider Demographics
NPI:1235960832
Name:HEART TO HOME QUALITY, COMFORT CARE, LLC
Entity type:Organization
Organization Name:HEART TO HOME QUALITY, COMFORT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEJA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-602-0211
Mailing Address - Street 1:8103 RED BOARD DR
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-7017
Mailing Address - Country:US
Mailing Address - Phone:317-602-0211
Mailing Address - Fax:
Practice Address - Street 1:8103 RED BOARD DR
Practice Address - Street 2:
Practice Address - City:CAMBY
Practice Address - State:IN
Practice Address - Zip Code:46113-7017
Practice Address - Country:US
Practice Address - Phone:317-602-0211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty