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General NPI Number Information
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NPI Number | 1134984461
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Entity Type | Organization
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Legal Business Name | HOUSE OF HEARTS II INC
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Dates
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Enumeration Date | 02/15/2024
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 753 W 144TH ST
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City | RIVERDALE
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State | IL
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Zip | 60827-2615
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Country | US
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Telephone | 708-880-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 4731 MIDLOTHIAN TPKE STE 32
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City | CRESTWOOD
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State | IL
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Zip | 60418-1990
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KRISTEN SARDIN
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Credential |
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Telephone | 773-499-4062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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