Provider Demographics
NPI:1245789932
Name:CAREFUL HEARTS SERVICES
Entity Type:Organization
Organization Name:CAREFUL HEARTS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-309-2008
Mailing Address - Street 1:269 REYNOLDS TER
Mailing Address - Street 2:UNIT 2
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-3305
Mailing Address - Country:US
Mailing Address - Phone:973-309-2008
Mailing Address - Fax:
Practice Address - Street 1:269 REYNOLDS TER
Practice Address - Street 2:UNIT 2
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-3305
Practice Address - Country:US
Practice Address - Phone:973-309-2008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health