Organization Name: | HEAVENLY HOSPICE CARE |
NPI Number: | 1902286925 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRANDIE FAUGHT (OWNER) |
Mailing Address: | 2174 S 600 W New Palestine |
State: | IN US |
Postal Code: | 461638986 |
Phone Number: | 3175347728 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2015 |
NPI Last Update Date: | 06/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |