Healthcare Provider Details

I. General information

NPI: 1790351989
Provider Name (Legal Business Name): HEART2HEART HHC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2021
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4642 THISTLE DR
DAYTON OH
45417-8938
US

IV. Provider business mailing address

9951 ATLANTIC BLVD STE 260
JACKSONVILLE FL
32225-6589
US

V. Phone/Fax

Practice location:
  • Phone: 937-823-6550
  • Fax: 937-815-1078
Mailing address:
  • Phone: 904-763-8877
  • Fax: 937-815-1078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL T WILKES
Title or Position: CEO
Credential:
Phone: 904-763-8877