Provider Demographics
NPI:1235832114
Name:HEART TO HEART PRENATAL AGENCEY LLC
Entity Type:Organization
Organization Name:HEART TO HEART PRENATAL AGENCEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PHAROAH
Authorized Official - Middle Name:O
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-389-0949
Mailing Address - Street 1:4001 W CAPITOL DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2530
Mailing Address - Country:US
Mailing Address - Phone:262-638-9094
Mailing Address - Fax:
Practice Address - Street 1:4001 W CAPITOL DR STE 2
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2530
Practice Address - Country:US
Practice Address - Phone:262-638-9094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management