Provider Demographics
NPI:1063705531
Name:HEART TO HEART COMPANION
Entity type:Organization
Organization Name:HEART TO HEART COMPANION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSING ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DALENCIA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:TWINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-838-6633
Mailing Address - Street 1:6771 LANDMARK WAY APT 14A
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-6509
Mailing Address - Country:US
Mailing Address - Phone:678-838-6633
Mailing Address - Fax:
Practice Address - Street 1:6771 LANDMARK WAY APT 14A
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168-6509
Practice Address - Country:US
Practice Address - Phone:678-838-6633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty