Provider Demographics
NPI:1639943566
Name:KINDHEARTED LLC
Entity Type:Organization
Organization Name:KINDHEARTED LLC
Other - Org Name:KINDHEARTED LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOATS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-957-8932
Mailing Address - Street 1:1902 KILLARNEY PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8109
Mailing Address - Country:US
Mailing Address - Phone:704-957-8932
Mailing Address - Fax:
Practice Address - Street 1:1902 KILLARNEY PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8109
Practice Address - Country:US
Practice Address - Phone:704-957-8932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-10
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care