Provider Demographics
NPI:1396290847
Name:HEARTS PERSONAL CARE HOME
Entity type:Organization
Organization Name:HEARTS PERSONAL CARE HOME
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-630-8882
Mailing Address - Street 1:9946 KIRKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-2207
Mailing Address - Country:US
Mailing Address - Phone:281-630-8882
Mailing Address - Fax:
Practice Address - Street 1:9946 KIRKSHIRE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-2207
Practice Address - Country:US
Practice Address - Phone:281-630-8882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health