Provider Demographics
NPI:1295771616
Name:KINDER HEARTS HOME HEALTH, LLC
Entity type:Organization
Organization Name:KINDER HEARTS HOME HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PHARISS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:325-672-6135
Mailing Address - Street 1:842 N MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79603-5729
Mailing Address - Country:US
Mailing Address - Phone:325-672-6135
Mailing Address - Fax:325-672-6176
Practice Address - Street 1:842 N MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79603-5729
Practice Address - Country:US
Practice Address - Phone:325-672-6135
Practice Address - Fax:325-672-6176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007897251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154314201Medicaid
TX154314201Medicaid