Provider Demographics
NPI:1134690308
Name:HEART TO HEART PERSOANL HOME CARE
Entity Type:Organization
Organization Name:HEART TO HEART PERSOANL HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKEISHA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-238-6428
Mailing Address - Street 1:1934 N GLENHOME DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-6892
Mailing Address - Country:US
Mailing Address - Phone:901-238-6428
Mailing Address - Fax:
Practice Address - Street 1:3225 KIRBY WHITTEN RD STE 201-3
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2893
Practice Address - Country:US
Practice Address - Phone:901-238-6428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care