Provider Demographics
NPI:1285199760
Name:HEART TO HEART HOME HEALTH CARE AGENCY LLC
Entity Type:Organization
Organization Name:HEART TO HEART HOME HEALTH CARE AGENCY LLC
Other - Org Name:HEART TO HEART HOME CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-990-6003
Mailing Address - Street 1:231 W COULTER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-3943
Mailing Address - Country:US
Mailing Address - Phone:610-990-6003
Mailing Address - Fax:
Practice Address - Street 1:231 W COULTER ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-3943
Practice Address - Country:US
Practice Address - Phone:610-990-6003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10398989Medicaid