Healthcare Provider Details

I. General information

NPI: 1851821532
Provider Name (Legal Business Name): HEART 2 HEART VETERANS CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2518 OSAGE AVE
LOUISVILLE KY
40210-1116
US

IV. Provider business mailing address

2518 OSAGE AVE
LOUISVILLE KY
40210-1116
US

V. Phone/Fax

Practice location:
  • Phone: 502-365-7388
  • Fax:
Mailing address:
  • Phone: 502-365-7388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number50103480
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAMIKA HINES
Title or Position: OWNER/MANAGER
Credential:
Phone: 502-365-7388