| Organization Name: | CARING HEARTS PEDIATRIC EXTENDED CARE CENTER, INC |
| NPI Number: | 1164631511 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LINDA SUE HAMMONTREE (ADMINISTRATOR) |
| Mailing Address: | 380 Medcrest Dr Crestview |
| State: | FL US |
| Postal Code: | 32536 |
| Phone Number: | 8504750555 |
| Fax Number: | 8504750650 |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 01/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM3000X |
| License Number: | 60080985 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Medically Fragile Intants and Children Day Care |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.). |