=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174265375
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEART 2 HEART HOMECARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/08/2022
-----------------------------------------------------
Last Update Date | 04/08/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4938 W COLONIAL DR STE 4
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32808-7720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-547-0283
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5248 LONG RD APT D
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32808-1105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-547-0283
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. ALLISON K SMITH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-547-0283
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------