Healthcare Provider Details

I. General information

NPI: 1659547545
Provider Name (Legal Business Name): HEARTS OF HOPE & ASSOCITATE,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 08/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 S HOUSTON LAKE RD BLDG K SUIT 300
WARNER ROBINS GA
31088-9027
US

IV. Provider business mailing address

524 S HOUSTON LAKE RD BLDG K SUIT 300
WARNER ROBINS GA
31088-9027
US

V. Phone/Fax

Practice location:
  • Phone: 478-297-9541
  • Fax:
Mailing address:
  • Phone: 478-297-9541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number076-R-0556
License Number StateGA

VIII. Authorized Official

Name: MRS. GERALDINE T JONES
Title or Position: CEO /ADMINISTRATOR
Credential:
Phone: 478-297-9541