Provider Demographics
NPI:1710922380
Name:HEART TO HEART HOSPICE, INC.
Entity Type:Organization
Organization Name:HEART TO HEART HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-854-6185
Mailing Address - Street 1:115A HIGHWAY 12 W
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-3761
Mailing Address - Country:US
Mailing Address - Phone:662-615-1519
Mailing Address - Fax:662-615-1554
Practice Address - Street 1:115A HIGHWAY 12 W
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-3761
Practice Address - Country:US
Practice Address - Phone:662-615-1519
Practice Address - Fax:662-615-1554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS105251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00770496Medicaid
MS00770496Medicaid