Provider Demographics
NPI:1437405610
Name:HEALING HEARTS FOUNDATION
Entity Type:Organization
Organization Name:HEALING HEARTS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW, LADAC
Authorized Official - Phone:901-726-4213
Mailing Address - Street 1:1384 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2327
Mailing Address - Country:US
Mailing Address - Phone:901-726-4213
Mailing Address - Fax:901-726-4281
Practice Address - Street 1:1384 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-2327
Practice Address - Country:US
Practice Address - Phone:901-726-4213
Practice Address - Fax:901-726-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000010152251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health