Provider Demographics
NPI:1922556554
Name:HEART FELT PERSONAL CARE LLC
Entity Type:Organization
Organization Name:HEART FELT PERSONAL CARE LLC
Other - Org Name:HEARTFELT PERSONAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-367-0111
Mailing Address - Street 1:2001 S JONES BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-3165
Mailing Address - Country:US
Mailing Address - Phone:702-367-0111
Mailing Address - Fax:
Practice Address - Street 1:2001 S JONES BLVD STE H
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3165
Practice Address - Country:US
Practice Address - Phone:702-367-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-12
Last Update Date:2023-07-31
Deactivation Date:2019-03-18
Deactivation Code:
Reactivation Date:2019-05-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1619323730OtherNPPES