MEDICARE: HELPING HEARTSELDERLY CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1033760921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELPING HEARTSELDERLY CARE

Provider Business Mailing Address
First Line	:	221 RUTHERS RD STE 101
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-5395
Country	:	US
Telephone Number	:	804-716-1104
Fax Number	:	804-716-1019

Provider Business Practice Location Address
First Line	:	221 RUTHERS RD STE 101
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-5395
Country	:	US
Telephone Number	:	804-716-1104
Fax Number	:	804-716-1019

Authorized Official
Title or Position	:	CEO
Name	:	JAMIEL ADEYOLA
Credential	:
Telephone Number	:	804-716-1104

Provider Enumeration Date	:	09/23/2019
Last Update Date	:	09/23/2019

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