Provider Demographics
NPI:1174176689
Name:A HEART 2 CARE HOME, LLC
Entity type:Organization
Organization Name:A HEART 2 CARE HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHALAKEE
Authorized Official - Middle Name:B
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-977-5225
Mailing Address - Street 1:1716 EMILY HOPE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-8460
Mailing Address - Country:US
Mailing Address - Phone:704-977-5225
Mailing Address - Fax:252-478-5537
Practice Address - Street 1:307 N PINE ST
Practice Address - Street 2:
Practice Address - City:SPRING HOPE
Practice Address - State:NC
Practice Address - Zip Code:27882-7889
Practice Address - Country:US
Practice Address - Phone:704-977-5225
Practice Address - Fax:252-478-5537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home