Provider Demographics
NPI:1831924836
Name:HEARTS OF CARE LLC
Entity type:Organization
Organization Name:HEARTS OF CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:ANDAMBI
Authorized Official - Last Name:ANZUGIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-287-6494
Mailing Address - Street 1:4528 MATTSON LN SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-3208
Mailing Address - Country:US
Mailing Address - Phone:859-287-6494
Mailing Address - Fax:
Practice Address - Street 1:4528 MATTSON LN SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-3208
Practice Address - Country:US
Practice Address - Phone:859-287-6494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care