Provider Demographics
NPI:1306371653
Name:A SERVANTS HEART HOME CARE
Entity type:Organization
Organization Name:A SERVANTS HEART HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:317-702-4834
Mailing Address - Street 1:857 HARVEST LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-8185
Mailing Address - Country:US
Mailing Address - Phone:317-702-4834
Mailing Address - Fax:
Practice Address - Street 1:857 HARVEST LAKE DR
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-8185
Practice Address - Country:US
Practice Address - Phone:317-702-4834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care