Provider Demographics
NPI:1235368721
Name:THE HEALING HEART CENTER, INC.
Entity Type:Organization
Organization Name:THE HEALING HEART CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED INDEPENDENT SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KUNDERT
Authorized Official - Suffix:
Authorized Official - Credentials:LISW,LCSW
Authorized Official - Phone:563-370-7995
Mailing Address - Street 1:1035 LINCOLN RD
Mailing Address - Street 2:SUITE 201-202
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4198
Mailing Address - Country:US
Mailing Address - Phone:563-370-7995
Mailing Address - Fax:309-659-7807
Practice Address - Street 1:1035 LINCOLN RD
Practice Address - Street 2:SUITE 201-202
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4198
Practice Address - Country:US
Practice Address - Phone:563-370-7995
Practice Address - Fax:309-659-7807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA015131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1063426328OtherINDIVIDUAL NPI #