Provider Demographics
NPI:1053150714
Name:A SMILE FROM MY HEART HEALTH CARE INC.
Entity type:Organization
Organization Name:A SMILE FROM MY HEART HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNDELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-729-3890
Mailing Address - Street 1:143 N MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4592
Mailing Address - Country:US
Mailing Address - Phone:757-729-3890
Mailing Address - Fax:757-942-8185
Practice Address - Street 1:143 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4592
Practice Address - Country:US
Practice Address - Phone:757-729-3890
Practice Address - Fax:757-942-8185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care