Healthcare Provider Details

I. General information

NPI: 1851137723
Provider Name (Legal Business Name): HEARTFELT IN-HOME CARE OF GEORGIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 MADISON ST STE 2
CLARKESVILLE GA
30523-5607
US

IV. Provider business mailing address

319 MADISON ST STE 2
CLARKESVILLE GA
30523-5607
US

V. Phone/Fax

Practice location:
  • Phone: 470-404-4076
  • Fax:
Mailing address:
  • Phone: 470-404-4076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: JACQUELIN UNDERWOOD
Title or Position: AREA DIRECTOR/OWNER
Credential:
Phone: 470-404-4076