MEDICARE: HEART TO HEART SOCIAL ADULT 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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1932540796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART TO HEART SOCIAL ADULT SERVICES LLC

Provider Business Mailing Address
First Line	:	227 EMPIRE BLVD.
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-3402
Country	:	US
Telephone Number	:	718-305-6060
Fax Number	:	718-305-6260

Provider Business Practice Location Address
First Line	:	209 EMPIRE BLVD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-3402
Country	:	US
Telephone Number	:	718-305-6200
Fax Number	:	718-305-6266

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JACOB ROSENBERG
Credential	:
Telephone Number	:	718-305-6060

Provider Enumeration Date	:	07/09/2013
Last Update Date	:	06/05/2015

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