1366575896 NPI number — CARING HEARTS HOME HEALTH SERVICES

Table of content: (NPI 1366575896)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366575896 NPI number — CARING HEARTS HOME HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARING HEARTS HOME HEALTH SERVICES
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:
Provider Other Organization Name Type Code:
6
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:
1366575896
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
235 ROOSEVELT AVE
Provider Second Line Business Mailing Address:
SUITE 260
Provider Business Mailing Address City Name:
ALBANY
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
229-434-4679
Provider Business Mailing Address Fax Number:
229-434-4692

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 ROOSEVELT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
229-434-4679
Provider Business Practice Location Address Fax Number:
229-434-4692
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
ADRIA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
ASST ADMN
Authorized Official Telephone Number:
229-434-4679

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  047-R-0031 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251J00000X , with the licence number: 047-R-0031 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00979063A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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