Provider Demographics
NPI:1336665058
Name:HEARTFUL SENIOR CARE LLC
Entity Type:Organization
Organization Name:HEARTFUL SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BERWANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-630-6599
Mailing Address - Street 1:537 VILLA DR
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:TX
Mailing Address - Zip Code:77586-3053
Mailing Address - Country:US
Mailing Address - Phone:832-630-6599
Mailing Address - Fax:281-215-5243
Practice Address - Street 1:537 VILLA DR
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:TX
Practice Address - Zip Code:77586-3053
Practice Address - Country:US
Practice Address - Phone:832-630-6599
Practice Address - Fax:281-215-5243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX802750108OtherIRS