MEDICARE: HALO AND HEARTS

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1588943120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALO AND HEARTS

Provider Business Mailing Address
First Line	:	4827 MONTCLAIR HILL LN
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-2037
Country	:	US
Telephone Number	:	713-514-4840
Fax Number	:

Provider Business Practice Location Address
First Line	:	4827 MONTCLAIR HILL LN
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-2037
Country	:	US
Telephone Number	:	713-514-4840
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	ANNYKEYSA MARIE HOLLOWAY
Credential	:
Telephone Number	:	713-514-4840

Provider Enumeration Date	:	08/14/2011
Last Update Date	:	08/14/2011

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Directions to “HALO AND HEARTS ” Practice Location

Language	Start Address	Practice Location

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