Provider Demographics
NPI:1932860996
Name:SHARING A HEART LLC
Entity type:Organization
Organization Name:SHARING A HEART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUANTAVIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-747-5768
Mailing Address - Street 1:3432 BLEDSOE RD LOT 54
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343-6711
Mailing Address - Country:US
Mailing Address - Phone:731-747-5768
Mailing Address - Fax:
Practice Address - Street 1:3432 BLEDSOE RD LOT 54
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:TN
Practice Address - Zip Code:38343-6711
Practice Address - Country:US
Practice Address - Phone:731-747-5768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services