Provider Demographics
NPI:1750925731
Name:HEALTHY HEARTS HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:HEALTHY HEARTS HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:267-250-7972
Mailing Address - Street 1:601 UPLAND AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19015-2456
Mailing Address - Country:US
Mailing Address - Phone:267-250-7972
Mailing Address - Fax:
Practice Address - Street 1:601 UPLAND AVE STE 205
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19015-2456
Practice Address - Country:US
Practice Address - Phone:267-250-7972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA31283601Medicaid