MEDICARE: HEART 2 HOME LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	251F00000X	Home Infusion Agency
3	251J00000X	Nursing Care Agency
4	385H00000X	Respite Care
5	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1881160372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART 2 HOME LLC

Provider Business Mailing Address
First Line	:	13201 NW FWY STE 800
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6157
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13201 NW FWY STE 800
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6157
Country	:	US
Telephone Number	:	504-473-3630
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KIANTE STAMPS
Credential	:	RN
Telephone Number	:	504-473-3630

Provider Enumeration Date	:	10/23/2018
Last Update Date	:	10/23/2018

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Directions to “HEART 2 HOME LLC ” Practice Location

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