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General NPI Number Information
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NPI Number | 1568168979
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Entity Type | Organization
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Legal Business Name | HEART CORE LLC
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 517 N. OAK ST
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City | COLE CAMP
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State | MO
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Zip | 65325
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Country | US
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Telephone | 660-668-3140
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Fax | 660-668-0108
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Provider Business Mailing Address
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Address Line | P.O BOX 252
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City | COLE CAMP
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State | MO
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Zip | 65325
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Country | US
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Telephone | 660-668-3140
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Fax | 660-668-0108
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Authorized Official
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Title or Position | OWNER
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Name | MR. ERIC LYNN FLICKINGER
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Credential |
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Telephone | 816-678-3871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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