Provider Demographics
NPI:1194696955
Name:HEALING HEARTS RESIDENTIAL AGENCY LLC
Entity type:Organization
Organization Name:HEALING HEARTS RESIDENTIAL AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:220-219-7210
Mailing Address - Street 1:364 CONSTANCE ST
Mailing Address - Street 2:
Mailing Address - City:LOCKBOURNE
Mailing Address - State:OH
Mailing Address - Zip Code:43137-9290
Mailing Address - Country:US
Mailing Address - Phone:220-219-7210
Mailing Address - Fax:
Practice Address - Street 1:364 CONSTANCE ST
Practice Address - Street 2:
Practice Address - City:LOCKBOURNE
Practice Address - State:OH
Practice Address - Zip Code:43137-9290
Practice Address - Country:US
Practice Address - Phone:220-219-7210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health