Provider Demographics
NPI:1215605571
Name:WISEST HEART, LLC
Entity Type:Organization
Organization Name:WISEST HEART, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:DIONISI
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:434-509-5235
Mailing Address - Street 1:520 TUGGLE RD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:VA
Mailing Address - Zip Code:23960-7919
Mailing Address - Country:US
Mailing Address - Phone:434-509-5235
Mailing Address - Fax:434-223-1713
Practice Address - Street 1:520 TUGGLE RD
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:VA
Practice Address - Zip Code:23960-7919
Practice Address - Country:US
Practice Address - Phone:434-509-5235
Practice Address - Fax:434-223-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes347C00000XTransportation ServicesPrivate VehicleGroup - Single Specialty