MEDICARE: HEARTIFY IN HOME CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1356237622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTIFY IN HOME CARE

Provider Business Mailing Address
First Line	:	5036 ESTONIAN DR
Second Line	:
City	:	FAIRBURN
State	:	GA
Zip	:	30213-2157
Country	:	US
Telephone Number	:	631-568-9144
Fax Number	:

Provider Business Practice Location Address
First Line	:	5036 ESTONIAN DR
Second Line	:
City	:	FAIRBURN
State	:	GA
Zip	:	30213-2157
Country	:	US
Telephone Number	:	631-568-9144
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TISHEKA NA LAIDLEY
Credential	:
Telephone Number	:	631-568-9144

Provider Enumeration Date	:	06/14/2025
Last Update Date	:	06/14/2025

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Directions to “HEARTIFY IN HOME CARE ” Practice Location

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