Provider Demographics
NPI:1093589186
Name:CANDID HEARTS HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:CANDID HEARTS HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MBUGUA
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:678-508-3700
Mailing Address - Street 1:851 WINDCROFT CIR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-3795
Mailing Address - Country:US
Mailing Address - Phone:678-508-3700
Mailing Address - Fax:
Practice Address - Street 1:851 WINDCROFT CIR NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-3795
Practice Address - Country:US
Practice Address - Phone:678-508-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health