Provider Demographics
NPI:1699757385
Name:HEARTFELT HOME CARE, INC.
Entity type:Organization
Organization Name:HEARTFELT HOME CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO / ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCCASKILL
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:407-909-1087
Mailing Address - Street 1:4305 VINELAND ROAD
Mailing Address - Street 2:SUITE G-16A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-7303
Mailing Address - Country:US
Mailing Address - Phone:407-956-1880
Mailing Address - Fax:407-826-1988
Practice Address - Street 1:2003 BARTOW RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-6556
Practice Address - Country:US
Practice Address - Phone:863-683-5010
Practice Address - Fax:863-683-5020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299991837251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651021300Medicaid
FL651021300Medicaid