1710108550 NPI number — HOPE FOR THE HEART HOME CARE AGENCY, INC.

Table of content: (NPI 1710108550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710108550 NPI number — HOPE FOR THE HEART HOME CARE AGENCY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOPE FOR THE HEART HOME CARE AGENCY, INC.
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:
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:
1710108550
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1138 WELLONS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28304-5053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-391-5566
Provider Business Mailing Address Fax Number:
910-339-4077

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
690 N REILLY RD
Provider Second Line Business Practice Location Address:
SUITE 8
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28303-5724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-391-5566
Provider Business Practice Location Address Fax Number:
910-339-4077
Provider Enumeration Date:
05/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RUFFIN
Authorized Official First Name:
GAIL
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
910-391-5566

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  1710108550 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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