Healthcare Provider Details

I. General information

NPI: 1518647577
Provider Name (Legal Business Name): OUR HEART TO YOURS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14042 MOUNT PLEASANT RD
JACKSONVILLE FL
32225-2508
US

IV. Provider business mailing address

14042 MOUNT PLEASANT RD
JACKSONVILLE FL
32225-2508
US

V. Phone/Fax

Practice location:
  • Phone: 904-405-3224
  • Fax:
Mailing address:
  • Phone: 904-206-3224
  • Fax:

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: ALAYA JOVAN DAVIS
Title or Position: CEO
Credential:
Phone: 904-206-3224