Provider Demographics
NPI:1225826845
Name:HOMEFRONT HOME HEALTH LLC
Entity type:Organization
Organization Name:HOMEFRONT HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DREW
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOTTERON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:260-363-0461
Mailing Address - Street 1:6821 LIMA RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46818-1145
Mailing Address - Country:US
Mailing Address - Phone:260-363-0461
Mailing Address - Fax:260-704-3922
Practice Address - Street 1:6821 LIMA RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46818-1145
Practice Address - Country:US
Practice Address - Phone:260-363-0461
Practice Address - Fax:260-704-3922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health