Provider Demographics
NPI:1619354172
Name:HEARTS TO HOME
Entity Type:Organization
Organization Name:HEARTS TO HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMAR
Authorized Official - Middle Name:ISSIAH
Authorized Official - Last Name:BRADSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-851-4581
Mailing Address - Street 1:72 BROADWAY # 1
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-4755
Mailing Address - Country:US
Mailing Address - Phone:508-851-4581
Mailing Address - Fax:
Practice Address - Street 1:72 BROADWAY #1
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832
Practice Address - Country:US
Practice Address - Phone:508-851-4581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS81081624251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health