Provider Demographics
NPI:1285132217
Name:BLUE HEARTS HOME HEALTH AGENCY
Entity type:Organization
Organization Name:BLUE HEARTS HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GUADALUPE
Authorized Official - Middle Name:L
Authorized Official - Last Name:TORREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:432-552-8578
Mailing Address - Street 1:2545 N TORRANCE AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79763-6053
Mailing Address - Country:US
Mailing Address - Phone:432-552-8578
Mailing Address - Fax:432-552-8578
Practice Address - Street 1:2545 N TORRANCE AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79763-6053
Practice Address - Country:US
Practice Address - Phone:432-552-8578
Practice Address - Fax:432-552-8578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health