Organization Name: | HEARTS OF GOLD, INC |
NPI Number: | 1770585036 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUE DODD (OWNER/ADMINISTRATOR) |
Mailing Address: | 38 5th Ave Shell Lake |
State: | WI US |
Postal Code: | 548714441 |
Phone Number: | 7154682931 |
Fax Number: | |
NPI Enumeration Date: | 06/01/2005 |
NPI Last Update Date: | 02/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | 304 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |