Provider Demographics
NPI:1578186102
Name:TRUE HEART OUT PATIENT SERVICES, LLC.
Entity Type:Organization
Organization Name:TRUE HEART OUT PATIENT SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:QMHP-A
Authorized Official - Phone:757-528-5397
Mailing Address - Street 1:813 FORREST DR STE B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4513
Mailing Address - Country:US
Mailing Address - Phone:757-528-5397
Mailing Address - Fax:757-223-3010
Practice Address - Street 1:813 FORREST DR STE B
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4513
Practice Address - Country:US
Practice Address - Phone:757-528-5397
Practice Address - Fax:757-223-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty