Provider Demographics
NPI:1053824664
Name:HEART HOME CARE
Entity Type:Organization
Organization Name:HEART HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:RMA
Authorized Official - Phone:517-908-1049
Mailing Address - Street 1:107 RICHARD AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-3433
Mailing Address - Country:US
Mailing Address - Phone:517-908-1049
Mailing Address - Fax:517-579-0277
Practice Address - Street 1:107 RICHARD AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-3433
Practice Address - Country:US
Practice Address - Phone:517-908-1049
Practice Address - Fax:517-579-0277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care