Healthcare Provider Details

I. General information

NPI: 1093107302
Provider Name (Legal Business Name): HEART TO HEART PROFESSIONAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2015
Last Update Date: 02/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 NE 1ST TER
POMPANO BEACH FL
33060-5006
US

IV. Provider business mailing address

1930 NE 1ST TER
POMPANO BEACH FL
33060-5006
US

V. Phone/Fax

Practice location:
  • Phone: 954-943-8590
  • Fax: 954-943-8590
Mailing address:
  • Phone: 954-943-8590
  • Fax: 954-943-8590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number232828
License Number StateFL

VIII. Authorized Official

Name: MS. NIKISHA CORLETTE THOMAS
Title or Position: PRESIDENT
Credential:
Phone: 754-281-1588