Provider Demographics
NPI:1437227626
Name:HEART TO HEART HOME CARE AGENCY, INC.
Entity Type:Organization
Organization Name:HEART TO HEART HOME CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-484-8080
Mailing Address - Street 1:6219 MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-2639
Mailing Address - Country:US
Mailing Address - Phone:910-480-1132
Mailing Address - Fax:910-484-9080
Practice Address - Street 1:2904 FORT BRAGG RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4725
Practice Address - Country:US
Practice Address - Phone:910-484-8080
Practice Address - Fax:910-484-9080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3222251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418081Medicaid
NC8301793BMedicaid
NC8301793Medicaid
NC6601411Medicaid
NC8301793GMedicaid