Provider Demographics
NPI:1619111978
Name:HEART 2 HEART HOME HEALTHCARE AGENCY
Entity Type:Organization
Organization Name:HEART 2 HEART HOME HEALTHCARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALTHEA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCLEISH WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CLNC
Authorized Official - Phone:954-243-9804
Mailing Address - Street 1:190 NE 199TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2927
Mailing Address - Country:US
Mailing Address - Phone:305-974-4822
Mailing Address - Fax:305-974-4825
Practice Address - Street 1:190 NE 199TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2927
Practice Address - Country:US
Practice Address - Phone:305-974-4822
Practice Address - Fax:305-974-4825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health