Provider Demographics
NPI:1396468633
Name:KINDRED HEARTS CARE PROVIDERS, LLC
Entity type:Organization
Organization Name:KINDRED HEARTS CARE PROVIDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZER
Authorized Official - Middle Name:
Authorized Official - Last Name:NJERU
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:770-882-8585
Mailing Address - Street 1:PO BOX 376
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-1017
Mailing Address - Country:US
Mailing Address - Phone:770-882-8585
Mailing Address - Fax:
Practice Address - Street 1:5610 CAVE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-3615
Practice Address - Country:US
Practice Address - Phone:770-882-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care