Provider Demographics
NPI:1447694054
Name:HUMANA AT HOME, INC.
Entity type:Organization
Organization Name:HUMANA AT HOME, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CLINICAL QUALITY
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-258-7709
Mailing Address - Street 1:845 3RD AVE
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6601
Mailing Address - Country:US
Mailing Address - Phone:212-994-6000
Mailing Address - Fax:
Practice Address - Street 1:2231 E CAMELBACK RD FL 4
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3453
Practice Address - Country:US
Practice Address - Phone:480-483-8531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUMANA INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-25
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health