Provider Demographics
NPI:1639665045
Name:HEARTFELT PERSONAL CARE
Entity Type:Organization
Organization Name:HEARTFELT PERSONAL CARE
Other - Org Name:HEARTFELT PERSONAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:TALIAFERRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-582-7062
Mailing Address - Street 1:207 N HUNTINGTON ST BLDG C
Mailing Address - Street 2:
Mailing Address - City:KOSCIUSKO
Mailing Address - State:MS
Mailing Address - Zip Code:39090-3351
Mailing Address - Country:US
Mailing Address - Phone:662-582-7062
Mailing Address - Fax:
Practice Address - Street 1:207 N HUNTINGTON ST BLDG C
Practice Address - Street 2:
Practice Address - City:KOSCIUSKO
Practice Address - State:MS
Practice Address - Zip Code:39090-3351
Practice Address - Country:US
Practice Address - Phone:662-582-7062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No347C00000XTransportation ServicesPrivate Vehicle
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty