1851401210 NPI number — SUPER HERO KIDS HOME HEALTH, LLC.

Table of content: (NPI 1851401210)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851401210 NPI number — SUPER HERO KIDS HOME HEALTH, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUPER HERO KIDS HOME HEALTH, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HEART TO HEART HOME CARE, LLC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851401210
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8700 CROWNHILL BLVD STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78209-1126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-937-1104
Provider Business Mailing Address Fax Number:
956-971-9314

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8700 CROWNHILL BLVD STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78209-1126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-937-1104
Provider Business Practice Location Address Fax Number:
956-971-9314
Provider Enumeration Date:
08/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ADAMS
Authorized Official First Name:
STEVAN
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
210-937-1104

Provider Taxonomy Codes

  • Taxonomy code: 133VN1004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 224Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 186603001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".