Provider Demographics
NPI:1699033274
Name:WOODLAND HEARTS, LLC
Entity Type:Organization
Organization Name:WOODLAND HEARTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:MARY LOUISE
Authorized Official - Last Name:GENTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-848-0705
Mailing Address - Street 1:6148 ELMDALE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKPARK
Mailing Address - State:OH
Mailing Address - Zip Code:44142-3903
Mailing Address - Country:US
Mailing Address - Phone:216-848-0705
Mailing Address - Fax:
Practice Address - Street 1:6148 ELMDALE RD
Practice Address - Street 2:
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-3903
Practice Address - Country:US
Practice Address - Phone:216-848-0705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care