Provider Demographics
NPI:1003132168
Name:HEART TO HEART YOUTH AND ENRICHMENT SERVICES INC.
Entity Type:Organization
Organization Name:HEART TO HEART YOUTH AND ENRICHMENT SERVICES INC.
Other - Org Name:HEART 2 HEART Y.E.S.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARONDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-476-7292
Mailing Address - Street 1:187 FAIR HAVEN WAY
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-9239
Mailing Address - Country:US
Mailing Address - Phone:803-462-4570
Mailing Address - Fax:803-753-7335
Practice Address - Street 1:187 FAIR HAVEN WAY
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-9239
Practice Address - Country:US
Practice Address - Phone:803-462-4570
Practice Address - Fax:803-753-7335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed ChildrenGroup - Single Specialty