Provider Demographics
NPI:1801264635
Name:HEARTSHARE
Entity type:Organization
Organization Name:HEARTSHARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCALANTE-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:718-441-5333
Mailing Address - Street 1:11515 101ST AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-1247
Mailing Address - Country:US
Mailing Address - Phone:718-441-5333
Mailing Address - Fax:
Practice Address - Street 1:11515 101ST AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1247
Practice Address - Country:US
Practice Address - Phone:718-441-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency