Healthcare Provider Details

I. General information

NPI: 1659715233
Provider Name (Legal Business Name): HEARTFELT HOME & COMMUNITY CARE OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2013
Last Update Date: 04/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 CARLISLE AVE S STE 1
LEHIGH ACRES FL
33974-7135
US

IV. Provider business mailing address

PO BOX 1419
LEHIGH ACRES FL
33970-1419
US

V. Phone/Fax

Practice location:
  • Phone: 239-297-0726
  • Fax: 888-958-5726
Mailing address:
  • Phone: 239-297-0726
  • Fax: 188-895-8572

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHAMFA MONIFA LAPORTA
Title or Position: CEO
Credential:
Phone: 239-297-0726