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General NPI Number Information
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NPI Number | 1639665045
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Entity Type | Organization
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Legal Business Name | HEARTFELT PERSONAL CARE
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 207 N HUNTINGTON ST BLDG C
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City | KOSCIUSKO
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State | MS
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Zip | 39090-3351
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Country | US
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Telephone | 662-582-7062
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Fax |
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Provider Business Mailing Address
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Address Line | 207 N HUNTINGTON ST BLDG C
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City | KOSCIUSKO
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State | MS
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Zip | 39090-3351
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Country | US
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Telephone | 662-582-7062
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DONNY TALIAFERRO
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Credential |
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Telephone | 662-582-7062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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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 | 372600000X
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Taxonomy Name | Adult Companion
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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