Healthcare Provider Details

I. General information

NPI: 1114557410
Provider Name (Legal Business Name): TWO HEARTS ONE LOVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2020
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 PIAVE ST
HAINES CITY FL
33844-7762
US

IV. Provider business mailing address

182 PIAVE ST
HAINES CITY FL
33844-7762
US

V. Phone/Fax

Practice location:
  • Phone: 863-934-1700
  • Fax: 863-268-8004
Mailing address:
  • Phone: 863-934-1700
  • Fax: 863-268-8004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SEANQUANEE DENAZIA CHANDLER
Title or Position: OWNER/OPERATOR
Credential:
Phone: 863-308-9192