Provider Demographics
NPI:1831766435
Name:HEALING HEARTS STAFFING & HOME HEALTH AGENCY, LLC
Entity type:Organization
Organization Name:HEALING HEARTS STAFFING & HOME HEALTH AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDSON-GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-234-4670
Mailing Address - Street 1:23 WAGON CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-7731
Mailing Address - Country:US
Mailing Address - Phone:407-234-4670
Mailing Address - Fax:
Practice Address - Street 1:23 WAGON CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34743-7731
Practice Address - Country:US
Practice Address - Phone:407-234-4670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care