Provider Demographics
NPI:1225513468
Name:HARMONY HEARTS VILLAGE LLC
Entity Type:Organization
Organization Name:HARMONY HEARTS VILLAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-442-3144
Mailing Address - Street 1:26730 BELANGER ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-3147
Mailing Address - Country:US
Mailing Address - Phone:248-221-2493
Mailing Address - Fax:
Practice Address - Street 1:7773 SHERWOOD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48211-1785
Practice Address - Country:US
Practice Address - Phone:313-442-3144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral DisturbancesGroup - Single Specialty
No174200000XOther Service ProvidersMeals
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome HealthGroup - Single Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental IllnessGroup - Single Specialty
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental IllnessGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI00000Medicaid