Provider Demographics
NPI:1285082636
Name:CARING HARTZ, LLC
Entity type:Organization
Organization Name:CARING HARTZ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SERVICE FACILITATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:CLEMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-742-2299
Mailing Address - Street 1:32272 EAST ST
Mailing Address - Street 2:
Mailing Address - City:BOYKINS
Mailing Address - State:VA
Mailing Address - Zip Code:23827-2656
Mailing Address - Country:US
Mailing Address - Phone:757-742-2299
Mailing Address - Fax:757-743-8006
Practice Address - Street 1:32272 EAST ST
Practice Address - Street 2:
Practice Address - City:BOYKINS
Practice Address - State:VA
Practice Address - Zip Code:23827-2656
Practice Address - Country:US
Practice Address - Phone:757-742-2299
Practice Address - Fax:757-743-8006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0185323448251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0185323448Medicaid