Provider Demographics
NPI:1215595277
Name:HEARTS2HEARTS ADULT FAMILY CARE HOMES
Entity Type:Organization
Organization Name:HEARTS2HEARTS ADULT FAMILY CARE HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TELFAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-492-3685
Mailing Address - Street 1:2120 PRESTON LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-0018
Mailing Address - Country:US
Mailing Address - Phone:727-492-3685
Mailing Address - Fax:
Practice Address - Street 1:301 SHAD WAY
Practice Address - Street 2:
Practice Address - City:POINCIANA
Practice Address - State:FL
Practice Address - Zip Code:34759-4730
Practice Address - Country:US
Practice Address - Phone:727-492-3725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health