Provider Demographics
NPI:1194929299
Name:HEARTFELT CARE LLC
Entity type:Organization
Organization Name:HEARTFELT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:TROUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CARE COORDINATOR
Authorized Official - Phone:907-345-0084
Mailing Address - Street 1:16131 WINDJAMMER CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-4813
Mailing Address - Country:US
Mailing Address - Phone:907-345-0084
Mailing Address - Fax:907-344-0075
Practice Address - Street 1:16131 WINDJAMMER CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99516-4813
Practice Address - Country:US
Practice Address - Phone:907-345-0084
Practice Address - Fax:907-344-0075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCM34981Medicaid
AKCMG654Medicaid