Provider Demographics
NPI:1326672577
Name:UNTIED HEARTS GROUP
Entity Type:Organization
Organization Name:UNTIED HEARTS GROUP
Other - Org Name:UNITED HEARTS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ABOUBACRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-745-1333
Mailing Address - Street 1:45487 PENTWATER DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-4236
Mailing Address - Country:US
Mailing Address - Phone:586-745-1333
Mailing Address - Fax:586-329-1117
Practice Address - Street 1:45487 PENTWATER DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-4236
Practice Address - Country:US
Practice Address - Phone:586-244-3697
Practice Address - Fax:586-329-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health