Provider Demographics
NPI:1508562661
Name:HEART OF CHARITIES
Entity Type:Organization
Organization Name:HEART OF CHARITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-424-6694
Mailing Address - Street 1:89 LASALLE AVE APT 314
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1452
Mailing Address - Country:US
Mailing Address - Phone:716-424-6694
Mailing Address - Fax:716-261-2719
Practice Address - Street 1:89 LASALLE AVE APT 314
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-1452
Practice Address - Country:US
Practice Address - Phone:716-424-6694
Practice Address - Fax:716-261-2719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care