Provider Demographics
NPI:1902472293
Name:GOOD HEARTS HOME CARE, LLC
Entity Type:Organization
Organization Name:GOOD HEARTS HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHEFFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-874-1639
Mailing Address - Street 1:3350 SW 148TH AVE # 216
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3257
Mailing Address - Country:US
Mailing Address - Phone:954-874-1639
Mailing Address - Fax:954-874-1699
Practice Address - Street 1:3350 SW 148TH AVE # 216
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3257
Practice Address - Country:US
Practice Address - Phone:954-874-1639
Practice Address - Fax:954-874-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299995285Medicaid