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General NPI Number Information
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NPI Number | 1063705531
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Entity Type | Organization
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Legal Business Name | HEART TO HEART COMPANION
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Dates
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Enumeration Date | 05/17/2011
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Last Update Date | 05/17/2011
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Provider Practice Location Address
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Address Line | 6771 LANDMARK WAY APT 14A
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City | AUSTELL
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State | GA
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Zip | 30168-6509
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Country | US
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Telephone | 678-838-6633
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Fax |
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Provider Business Mailing Address
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Address Line | 6771 LANDMARK WAY APT 14A
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City | AUSTELL
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State | GA
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Zip | 30168-6509
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Country | US
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Telephone | 678-838-6633
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Fax |
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Authorized Official
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Title or Position | CERTIFIED NURSING ASSISTANT
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Name | MRS. DALENCIA DENISE TWINE
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Credential |
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Telephone | 678-838-6633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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