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General NPI Number Information
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NPI Number | 1780840793
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Entity Type | Organization
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Legal Business Name | HEARTS AT HOME, INC
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 1398 PALM BAY RD NE
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City | PALM BAY
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State | FL
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Zip | 32905-3837
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Country | US
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Telephone | 321-676-0103
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Fax | 321-676-0106
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Provider Business Mailing Address
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Address Line | 1398 PALM BAY RD NE
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City | PALM BAY
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State | FL
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Zip | 32905-3837
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Country | US
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Telephone | 321-676-0103
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Fax | 321-676-0106
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MS. ALICE A GUILFORD
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Credential |
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Telephone | 321-676-0103
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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 | 19966214
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License Number State | FL
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