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General NPI Number Information
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NPI Number | 1558726596
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Entity Type | Organization
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Legal Business Name | HEART TO HEART PCS AGENCY
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Dates
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Enumeration Date | 12/17/2015
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 6814 CRUMPLER BLVD # 201-D
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-1905
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Country | US
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Telephone | 662-932-2147
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Fax | 662-932-2148
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Provider Business Mailing Address
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Address Line | 6814 CRUMPLER BLVD # 201-D
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-1905
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Country | US
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Telephone | 662-932-2147
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Fax | 662-932-2148
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. CARRIE A KENNEDY
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Credential |
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Telephone | 901-756-5918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 25100000X
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License Number State | MS
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