Provider Demographics
NPI:1083005821
Name:OUR HEARTS YOUR HOME
Entity Type:Organization
Organization Name:OUR HEARTS YOUR HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:SHAUNTAE
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1888-648-9960
Mailing Address - Street 1:PO BOX 38162
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38183-0162
Mailing Address - Country:US
Mailing Address - Phone:888-648-9960
Mailing Address - Fax:
Practice Address - Street 1:5111 SHADOW CREST CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-0002
Practice Address - Country:US
Practice Address - Phone:888-648-9960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1896253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care