Provider Demographics
NPI:1740825801
Name:BLUEHEART ADULT DAY CARE CENTER
Entity type:Organization
Organization Name:BLUEHEART ADULT DAY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLETHA
Authorized Official - Middle Name:EDNETTA
Authorized Official - Last Name:BLUE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:561-352-9728
Mailing Address - Street 1:1917 MONTAGUE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-6057
Mailing Address - Country:US
Mailing Address - Phone:561-352-9728
Mailing Address - Fax:
Practice Address - Street 1:1917 MONTAGUE ST
Practice Address - Street 2:
Practice Address - City:LAKE WORTH BEACH
Practice Address - State:FL
Practice Address - Zip Code:33461-6057
Practice Address - Country:US
Practice Address - Phone:561-352-9728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility