Provider Demographics
NPI:1033417167
Name:WEE HEARTS
Entity Type:Organization
Organization Name:WEE HEARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DARSEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:707-628-4554
Mailing Address - Street 1:10049 MAGNOLIA BLVD
Mailing Address - Street 2:539
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606
Mailing Address - Country:US
Mailing Address - Phone:707-628-4554
Mailing Address - Fax:
Practice Address - Street 1:10049 MAGNOLIA BLVD
Practice Address - Street 2:539
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606
Practice Address - Country:US
Practice Address - Phone:707-628-4554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5384653140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric