Healthcare Provider Details

I. General information

NPI: 1891687414
Provider Name (Legal Business Name): HEART AND HOME SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HAYWOOD RD
COVENTRY RI
02816-5964
US

IV. Provider business mailing address

10 HAYWOOD RD
COVENTRY RI
02816-5964
US

V. Phone/Fax

Practice location:
  • Phone: 724-255-1780
  • Fax:
Mailing address:
  • Phone: 724-255-1780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: AUTUMN COLBERT
Title or Position: OWNER
Credential:
Phone: 724-255-1780