Provider Demographics
NPI:1528306826
Name:HEART 2 HEART HEALTHSERVICE AND ADULTDAYCARE
Entity type:Organization
Organization Name:HEART 2 HEART HEALTHSERVICE AND ADULTDAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-534-4929
Mailing Address - Street 1:413 W 109TH PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90061-1513
Mailing Address - Country:US
Mailing Address - Phone:909-534-4929
Mailing Address - Fax:
Practice Address - Street 1:413 W 109TH PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90061-1513
Practice Address - Country:US
Practice Address - Phone:909-534-4929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLOURISH 4 LIFE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care