Organization Active NPI

Heart & Life Community Center Inc

  • Community/Behavioral Health Agency
  • Gainesville, FL
National Provider Identifier
1871264507
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
HEART & LIFE COMMUNITY CENTER INC
Practice address
309 NE 1St St Ste B
Gainesville, FL 32601-5310
Phone
(407) 730-5306
Fax
(407) 730-5305
NPI assigned
Sep 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carmen Guzman, CCMS
Title
Office Manager
Phone
(407) 730-5306

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

309 NE 1St St Ste B
Gainesville, FL 32601-5310

Mailing address

801 N Magnolia Ave Ste 201
Orlando, FL 32803-3842
Phone (407) 730-5306

Other identifiers 1

IdentifierTypeStateIssuer
109829400MedicaidFL

Other names 1

  • Heart & Life Community Center Inc Former legal business name

National Provider Directory

National Provider Directory

Locations

309 NE 1st St
Ste B
Gainesville, FL 32601
Phone (407) 730-5306

801 N Magnolia Ave
Ste 201
Orlando, FL 32803
Phone (407) 730-5306

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1871264507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N MAGNOLIA AVE STE 201",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033842",
            "telephone_number": "407-730-5306",
            "fax_number": "407-730-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 NE 1ST ST STE B",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326015310",
            "telephone_number": "407-730-5306",
            "fax_number": "407-730-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART & LIFE COMMUNITY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "GUZMAN",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "407-730-5306",
        "authorized_official_credential": "CCMS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109829400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heart & Life Community Center Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.