Provider Demographics
NPI:1639522717
Name:HEARTS OF IRELAND REFERRAL AGENCY OF MD, LLC
Entity Type:Organization
Organization Name:HEARTS OF IRELAND REFERRAL AGENCY OF MD, LLC
Other - Org Name:HEARTS OF IRELAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CAVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CNA
Authorized Official - Phone:800-374-2669
Mailing Address - Street 1:305 W CHESAPEAKE AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4421
Mailing Address - Country:US
Mailing Address - Phone:800-374-2669
Mailing Address - Fax:443-279-2907
Practice Address - Street 1:305 W CHESAPEAKE AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4421
Practice Address - Country:US
Practice Address - Phone:800-374-2669
Practice Address - Fax:443-279-2907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNR080805251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health