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General NPI Number Information
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NPI Number | 1487023602
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Entity Type | Organization
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Legal Business Name | HEAVENLY HEARTS SERVICES LLC
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 2565 N TOLEDO BLADE BLVD UNIT 1
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City | NORTH PORT
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State | FL
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Zip | 34289-9306
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Country | US
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Telephone | 941-525-8945
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Fax |
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Provider Business Mailing Address
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Address Line | 2565 N TOLEDO BLADE BLVD UNIT 1
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City | NORTH PORT
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State | FL
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Zip | 34289-9306
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Country | US
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Telephone | 941-525-8945
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JANETH RODRIGUEZ
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Credential |
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Telephone | 941-525-8945
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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 | 232623
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License Number State | FL
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