Organization
ENCHANTED HEARTS PROVIDER SERVICES LLC
Active
Other names
Enchanted Hearts Provider Services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DORIAN OLEVIA MARTIN RN (CEO)
(409) 527-1121
Entity
Organization
Contact information
Practice address
825 BOYD ST, BEAUMONT, TX 77705-5007
(409) 527-1121
Mailing address
825 BOYD ST, BEAUMONT, TX 77705-5007
(409) 527-1121
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
04/21/2023
Last updated
04/21/2023
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