Provider Demographics
NPI:1104272970
Name:RICH AT HEART HEALTHCARE
Entity type:Organization
Organization Name:RICH AT HEART HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TIJUANA
Authorized Official - Middle Name:SHEREE
Authorized Official - Last Name:IRVING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-575-7963
Mailing Address - Street 1:7501 NE 52ND TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-1216
Mailing Address - Country:US
Mailing Address - Phone:352-575-7963
Mailing Address - Fax:
Practice Address - Street 1:7501 NE 52ND TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-1216
Practice Address - Country:US
Practice Address - Phone:352-575-7963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency