Provider Demographics
NPI:1003416496
Name:HEALING HEARTSNC
Entity Type:Organization
Organization Name:HEALING HEARTSNC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LASHAI
Authorized Official - Middle Name:R
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-213-4319
Mailing Address - Street 1:PO BOX 264
Mailing Address - Street 2:
Mailing Address - City:CLARKTON
Mailing Address - State:NC
Mailing Address - Zip Code:28433-0264
Mailing Address - Country:US
Mailing Address - Phone:336-213-4319
Mailing Address - Fax:
Practice Address - Street 1:1364 HWY 211 WEST
Practice Address - Street 2:
Practice Address - City:CLARKTON
Practice Address - State:NC
Practice Address - Zip Code:28433
Practice Address - Country:US
Practice Address - Phone:336-213-4319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health