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General NPI Number Information
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NPI Number | 1861249070
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Entity Type | Organization
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Legal Business Name | HEART TO HART HOME CARE LLC
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Dates
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Enumeration Date | 05/04/2024
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Last Update Date | 05/04/2024
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Provider Practice Location Address
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Address Line | 5604 TRAIL LAKE DR
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City | FORT WORTH
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State | TX
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Zip | 76133-2532
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Country | US
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Telephone | 734-620-4398
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Fax |
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Provider Business Mailing Address
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Address Line | 5604 TRAIL LAKE DR
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City | FORT WORTH
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State | TX
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Zip | 76133-2532
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Country | US
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Telephone | 734-620-4398
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Fax |
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Authorized Official
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Title or Position | OWNER/ ADMINISTRATOR
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Name | KYREE DANYEL THOMAS HARTLEY
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Credential | LVN
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Telephone | 734-620-4398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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