Healthcare Provider Details

I. General information

NPI: 1073429262
Provider Name (Legal Business Name): HEALING HEARTS HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 GREEN RIVER RD
CORONA CA
92878-5301
US

IV. Provider business mailing address

4901 GREEN RIVER RD SPC 16
CORONA CA
92878-5674
US

V. Phone/Fax

Practice location:
  • Phone: 951-987-7364
  • Fax:
Mailing address:
  • Phone: 951-987-7364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: STASIA SHIMKUS
Title or Position: OWNER
Credential:
Phone: 951-987-7364