Provider Demographics
NPI:1174021398
Name:GRATEFUL HEARTS LLC
Entity Type:Organization
Organization Name:GRATEFUL HEARTS LLC
Other - Org Name:GRATEFUL HEARTS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHEIF EXCECUITIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-477-7384
Mailing Address - Street 1:18 CAMPUS BLVD STE 141
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3245
Mailing Address - Country:US
Mailing Address - Phone:484-477-7384
Mailing Address - Fax:
Practice Address - Street 1:18 CAMPUS BLVD STE 141
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3245
Practice Address - Country:US
Practice Address - Phone:484-477-7384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA36303601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health