Provider Demographics
NPI:1619033750
Name:HEHLLC
Entity type:Organization
Organization Name:HEHLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HARE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:904-543-1778
Mailing Address - Street 1:117 SOLANO CAY CIR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-2242
Mailing Address - Country:US
Mailing Address - Phone:904-543-1778
Mailing Address - Fax:904-543-1755
Practice Address - Street 1:117 SOLANO CAY CIR
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-2242
Practice Address - Country:US
Practice Address - Phone:904-543-1778
Practice Address - Fax:904-543-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL229797251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health