Provider Demographics
NPI:1194334045
Name:HEARTS OF GOLD CARE INC
Entity type:Organization
Organization Name:HEARTS OF GOLD CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WITHROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-956-2443
Mailing Address - Street 1:PO BOX 534
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-0534
Mailing Address - Country:US
Mailing Address - Phone:503-956-2443
Mailing Address - Fax:
Practice Address - Street 1:700 E PORT MARINA DR
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2382
Practice Address - Country:US
Practice Address - Phone:503-956-2443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care