Provider Demographics
NPI:1083776579
Name:HEARTSPRING, INC.
Entity Type:Organization
Organization Name:HEARTSPRING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:FURMAN
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:M ED, QP
Authorized Official - Phone:704-366-6522
Mailing Address - Street 1:3707 LATROBE DR STE 460
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1361
Mailing Address - Country:US
Mailing Address - Phone:704-366-6522
Mailing Address - Fax:704-366-6529
Practice Address - Street 1:3707 LATROBE DR STE 460
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1361
Practice Address - Country:US
Practice Address - Phone:704-366-6522
Practice Address - Fax:704-366-6529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409285Medicaid