MEDICARE: HEARTBRIDGE HOME CARE 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	:	1831046374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTBRIDGE HOME CARE LLC

Provider Business Mailing Address
First Line	:	3189 KIRBY WHITTEN RD STE 203A
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38134-2854
Country	:	US
Telephone Number	:	901-779-7508
Fax Number	:	877-497-2554

Provider Business Practice Location Address
First Line	:	3189 KIRBY WHITTEN RD STE 203A
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38134-2854
Country	:	US
Telephone Number	:	901-779-7508
Fax Number	:	877-497-2554

Authorized Official
Title or Position	:	AGENCY DIRECTOR
Name	:	ALYCIA COLLINS
Credential	:
Telephone Number	:	901-779-7508

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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