Provider Demographics
NPI:1285287656
Name:FROM THE HEART PHILADELPHIA, LLC
Entity type:Organization
Organization Name:FROM THE HEART PHILADELPHIA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:AUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-486-5330
Mailing Address - Street 1:10 CROSSROADS DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117
Mailing Address - Country:US
Mailing Address - Phone:410-486-5330
Mailing Address - Fax:724-590-5148
Practice Address - Street 1:2 BALA PLAZA
Practice Address - Street 2:SUITE 300
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004
Practice Address - Country:US
Practice Address - Phone:267-603-8933
Practice Address - Fax:567-388-4716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1035870600001Medicaid