Provider Demographics
NPI:1780294645
Name:BIG HEARTS AT HOME CARE, LLC
Entity type:Organization
Organization Name:BIG HEARTS AT HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:LAPORSHA
Authorized Official - Middle Name:C
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-609-1990
Mailing Address - Street 1:572 DOVER RD STE A
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-6035
Mailing Address - Country:US
Mailing Address - Phone:615-609-1990
Mailing Address - Fax:
Practice Address - Street 1:572 DOVER RD STE A
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-6035
Practice Address - Country:US
Practice Address - Phone:615-609-1990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care