Provider Demographics
NPI:1578386876
Name:NOURISHING HEARTS HOME HEALTH
Entity type:Organization
Organization Name:NOURISHING HEARTS HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:KHADIJA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEYLANI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:952-261-2324
Mailing Address - Street 1:4240 BLUE RIDGE BLVD STE 611D
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-1723
Mailing Address - Country:US
Mailing Address - Phone:952-261-2324
Mailing Address - Fax:
Practice Address - Street 1:4240 BLUE RIDGE BLVD STE 611D
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-1723
Practice Address - Country:US
Practice Address - Phone:952-261-2324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty