Provider Demographics
NPI:1932454675
Name:ANIYA'S HEART HOME CARE AGENCY, INC.
Entity Type:Organization
Organization Name:ANIYA'S HEART HOME CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:LUCRETIA
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:910-840-1453
Mailing Address - Street 1:24464 PEACOCK RD
Mailing Address - Street 2:
Mailing Address - City:TABOR CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28463-7086
Mailing Address - Country:US
Mailing Address - Phone:910-840-1453
Mailing Address - Fax:
Practice Address - Street 1:24464 PEACOCK RD
Practice Address - Street 2:
Practice Address - City:TABOR CITY
Practice Address - State:NC
Practice Address - Zip Code:28463-7086
Practice Address - Country:US
Practice Address - Phone:910-840-1453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4555253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care