Provider Demographics
NPI:1497589105
Name:AT HOME HEALERS HOME CARE
Entity type:Organization
Organization Name:AT HOME HEALERS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANTELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTER-BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:260-702-0897
Mailing Address - Street 1:7840 SOUTHTOWN XING STE 104
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46816-2518
Mailing Address - Country:US
Mailing Address - Phone:260-702-0897
Mailing Address - Fax:
Practice Address - Street 1:7840 SOUTHTOWN XING STE 104
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46816-2518
Practice Address - Country:US
Practice Address - Phone:260-702-0897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care