Provider Demographics
NPI:1376312173
Name:HEART TO HEART CONSOLIDATED HOME CARE SERVCIE 2 LLC
Entity Type:Organization
Organization Name:HEART TO HEART CONSOLIDATED HOME CARE SERVCIE 2 LLC
Other - Org Name:HEART TO HEART CONSOLIDATED HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAKOHASHI
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-849-0005
Mailing Address - Street 1:4625 LINDELL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-3725
Mailing Address - Country:US
Mailing Address - Phone:314-396-8127
Mailing Address - Fax:314-932-5033
Practice Address - Street 1:4625 LINDELL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-3725
Practice Address - Country:US
Practice Address - Phone:314-396-8127
Practice Address - Fax:314-932-5033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health