Provider Demographics
NPI:1942775689
Name:MENDING HEARTS, LLC
Entity Type:Organization
Organization Name:MENDING HEARTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:205-542-6543
Mailing Address - Street 1:2172 PELHAM PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1163
Mailing Address - Country:US
Mailing Address - Phone:205-542-6543
Mailing Address - Fax:
Practice Address - Street 1:201 1ST ST SW
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8527
Practice Address - Country:US
Practice Address - Phone:205-725-1544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care