Provider Demographics
NPI:1699486027
Name:H.E.A.R.T. HOME CARE OF GA LLC
Entity type:Organization
Organization Name:H.E.A.R.T. HOME CARE OF GA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA/CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-869-5945
Mailing Address - Street 1:1000 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3749
Mailing Address - Country:US
Mailing Address - Phone:229-869-5945
Mailing Address - Fax:
Practice Address - Street 1:414 N WESTOVER BLVD STE D4
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2102
Practice Address - Country:US
Practice Address - Phone:229-869-5945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care