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General NPI Number Information
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NPI Number | 1982394862
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Entity Type | Organization
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Legal Business Name | OUR HEARTS YOUR HOME LLC
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 4840 HATTERAS RD
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City | JACKSONVILLE
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State | FL
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Zip | 32208-1853
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Country | US
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Telephone | 904-422-1345
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Fax | 904-439-7613
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Provider Business Mailing Address
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Address Line | 14573 CHRISTEN DR
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City | JACKSONVILLE
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State | FL
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Zip | 32218-0827
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Country | US
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Telephone | 904-422-1345
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | IMAN HALL
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Credential | RN
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Telephone | 904-422-1345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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