Provider Demographics
NPI:1013373117
Name:HEART TO HOME INCORPORATED
Entity Type:Organization
Organization Name:HEART TO HOME INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CESARO-MOXLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-485-8738
Mailing Address - Street 1:659 FREEWAY RD S
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55118-4314
Mailing Address - Country:US
Mailing Address - Phone:651-485-8738
Mailing Address - Fax:651-686-5295
Practice Address - Street 1:2351 PAGEL RD
Practice Address - Street 2:
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120-1638
Practice Address - Country:US
Practice Address - Phone:651-994-2020
Practice Address - Fax:651-686-5295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25755310400000X, 311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)