Provider Demographics
NPI:1376676684
Name:HEALING HEARTS OF TN, INC
Entity Type:Organization
Organization Name:HEALING HEARTS OF TN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-474-4673
Mailing Address - Street 1:107 E MORFORD ST
Mailing Address - Street 2:
Mailing Address - City:MC MINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-2521
Mailing Address - Country:US
Mailing Address - Phone:931-474-4763
Mailing Address - Fax:931-474-4764
Practice Address - Street 1:107 E MORFORD ST
Practice Address - Street 2:
Practice Address - City:MC MINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2521
Practice Address - Country:US
Practice Address - Phone:931-474-4763
Practice Address - Fax:931-474-4764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN457801OtherVALUE OPTIONS
TN$$$$$$$$$OtherSOCIAL SECURITY
TN7239269OtherAETNA
TN4094346OtherBLUE CROSS BLUE SHIELD
TN$$$$$$$$$OtherSOCIAL SECURITY
TN40999839OtherBLUE CROSS BLUE SHIELD
TN2072152OtherCIGNA
TN4080157OtherBLUE CROSS BLUE SHIELD
TN$$$$$$$$$OtherSOCIAL SECURITY