Provider Demographics
NPI:1750554812
Name:CARING HEARTS MEDICAL SERVICES
Entity type:Organization
Organization Name:CARING HEARTS MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BILLING ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:STELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-826-7477
Mailing Address - Street 1:PO BOX 741
Mailing Address - Street 2:507 SOUTH BRIDGE STREET
Mailing Address - City:WASHINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70589-0741
Mailing Address - Country:US
Mailing Address - Phone:337-826-7477
Mailing Address - Fax:337-826-7479
Practice Address - Street 1:507 SOUTH BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:LA
Practice Address - Zip Code:70589
Practice Address - Country:US
Practice Address - Phone:337-826-7477
Practice Address - Fax:337-826-7479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12127251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1625311Medicaid