Provider Demographics
NPI:1063950780
Name:HEART TO HEARTS CARE
Entity type:Organization
Organization Name:HEART TO HEARTS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHUMALO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-675-9058
Mailing Address - Street 1:10881 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2226
Mailing Address - Country:US
Mailing Address - Phone:951-675-9058
Mailing Address - Fax:
Practice Address - Street 1:15437 ANACAPA RD
Practice Address - Street 2:SUIT 31
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-2458
Practice Address - Country:US
Practice Address - Phone:951-675-9058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEART TO HEARTS CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201210710137253Z00000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care