MEDICARE: CARING HEARTS AHS INC

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	310400000X	Assisted Living Facility	AL 12525	FL

General Provider Information

NPI Number	:	1780092551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARING HEARTS AHS INC

Provider Business Mailing Address
First Line	:	5720 FEARNLEY RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-6436
Country	:	US
Telephone Number	:	561-507-5059
Fax Number	:	561-507-5059

Provider Business Practice Location Address
First Line	:	5720 FEARNLEY RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-6436
Country	:	US
Telephone Number	:	561-507-5059
Fax Number	:	561-507-5059

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	MAURICE H SMITH
Credential	:
Telephone Number	:	561-503-0205

Provider Enumeration Date	:	07/24/2014
Last Update Date	:	07/24/2014

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