Provider Demographics
NPI:1730174848
Name:HEARTHSTONE HEALTHCARE
Entity type:Organization
Organization Name:HEARTHSTONE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STRUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-665-6526
Mailing Address - Street 1:PO BOX 584
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-0584
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 ASBURY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-9639
Practice Address - Country:US
Practice Address - Phone:828-665-6526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC 2954251E00000X
NCHC 2049251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600780Medicaid
NC3409326Medicaid