Provider Demographics
NPI: | 1871352609 |
---|---|
Name: | SINCERE HEART HEALTHCARE INC |
Entity type: | Organization |
Organization Name: | SINCERE HEART HEALTHCARE INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF NURSING OFFICER/REGISTERED CM |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JUWANDA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SMITH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | REGISTERED NURSE |
Authorized Official - Phone: | 513-591-9302 |
Mailing Address - Street 1: | 6912 S 30TH LN |
Mailing Address - Street 2: | |
Mailing Address - City: | PHOENIX |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85041-9310 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 513-591-9302 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4150 W PEORIA AVE STE 117 |
Practice Address - Street 2: | |
Practice Address - City: | PHOENIX |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85029-3950 |
Practice Address - Country: | US |
Practice Address - Phone: | 513-591-9302 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-03-14 |
Last Update Date: | 2024-12-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Multi-Specialty | |
No | 132700000X | Dietary & Nutritional Service Providers | Dietary Manager | Group - Multi-Specialty | |
No | 163WC0400X | Nursing Service Providers | Registered Nurse | Case Management | Group - Multi-Specialty |
No | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | Group - Multi-Specialty | |
No | 221700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Art Therapist | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225A00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Music Therapist | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | ||
No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
No | 376G00000X | Nursing Service Related Providers | Nursing Home Administrator | Group - Multi-Specialty | |
No | 376K00000X | Nursing Service Related Providers | Nurse's Aide | Group - Multi-Specialty |