Provider Demographics
NPI:1255562070
Name:HEARTFELT SERVICES, INC.
Entity type:Organization
Organization Name:HEARTFELT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:352-368-9036
Mailing Address - Street 1:2925 NW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34475-2645
Mailing Address - Country:US
Mailing Address - Phone:352-368-9036
Mailing Address - Fax:501-647-9036
Practice Address - Street 1:2925 NW 4TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34475-2645
Practice Address - Country:US
Practice Address - Phone:352-368-9036
Practice Address - Fax:501-647-9036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251300000X, 253Z00000X, 311ZA0620X, 385HR2060X
FLRN2681892251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251300000XAgenciesLocal Education Agency (LEA)
No253Z00000XAgenciesIn Home Supportive Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL679698296OtherAGENCY FOR PEOPLE WITH DISABILITIES
FL679698201OtherAGENCY FOR PEOPLE WITH DISABILITIES-FSL