Healthcare Provider Details

I. General information

NPI: 1174139307
Provider Name (Legal Business Name): HEART MATTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9037 FIELDING ST
DETROIT MI
48228-1670
US

IV. Provider business mailing address

PO BOX 28099
DETROIT MI
48228-0099
US

V. Phone/Fax

Practice location:
  • Phone: 313-728-0469
  • Fax:
Mailing address:
  • Phone: 313-231-8386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHARLENE CHANDLER
Title or Position: FOUNDER/CEO
Credential:
Phone: 313-728-0469