Healthcare Provider Details

I. General information

NPI: 1972204204
Provider Name (Legal Business Name): OUR HEARTS HOME CARE & STAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2023
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W BAY DR # 113
LARGO FL
33770-3269
US

IV. Provider business mailing address

235 APOLLO BEACH BLVD # 182
APOLLO BEACH FL
33572-2251
US

V. Phone/Fax

Practice location:
  • Phone: 727-202-3838
  • Fax: 866-757-5858
Mailing address:
  • Phone: 813-603-3096
  • Fax: 866-757-5858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHEVELLE R JORDAN
Title or Position: OWNER
Credential: RN
Phone: 727-202-3838