MEDICARE: HEART TO HEART HOME 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	251E00000X	Home Health Agency	6583322-0151	UT

General Provider Information

NPI Number	:	1154510931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART TO HEART HOME CARE

Provider Business Mailing Address
First Line	:	PO BOX 306
Second Line	:
City	:	WASHINGTON
State	:	UT
Zip	:	84780-0306
Country	:	US
Telephone Number	:	435-986-1077
Fax Number	:	435-986-1270

Provider Business Practice Location Address
First Line	:	2686 E 10 NORTH CIR
Second Line	:
City	:	ST GEORGE
State	:	UT
Zip	:	84790-9098
Country	:	US
Telephone Number	:	435-986-1077
Fax Number	:	435-986-1270

Authorized Official
Title or Position	:	OWNER/ MANAGER
Name	:	MRS. LAURA KELSO
Credential	:
Telephone Number	:	435-986-1077

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	10/17/2007

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Directions to “HEART TO HEART HOME CARE ” Practice Location

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