Provider Demographics
NPI:1265084297
Name:CARE FROM THE HEART IN HOME SERVICES, INC.
Entity type:Organization
Organization Name:CARE FROM THE HEART IN HOME SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:831-476-8316
Mailing Address - Street 1:3141 PAUL SWEET ROAD
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065
Mailing Address - Country:US
Mailing Address - Phone:831-476-8316
Mailing Address - Fax:
Practice Address - Street 1:3141 PAUL SWEET ROAD
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065
Practice Address - Country:US
Practice Address - Phone:831-476-8316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA444700004OtherSTATE OF CALIFORNIA SOCIAL SERVICES