MEDICARE: HEALING HEARTS SERVICES LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1588437248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HEARTS SERVICES LLC

Provider Business Mailing Address
First Line	:	5105 FORT SUMTER RD # 4S
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27606-2384
Country	:	US
Telephone Number	:	804-338-9475
Fax Number	:

Provider Business Practice Location Address
First Line	:	4111 ROSE LAKE DR # 6264
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-2829
Country	:	US
Telephone Number	:	888-462-3453
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	HOWARD GREGORY WOODEN JR.
Credential	:
Telephone Number	:	804-338-9475

Provider Enumeration Date	:	11/03/2023
Last Update Date	:	11/03/2023

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