Provider Demographics
NPI:1598232258
Name:HEART TOUCH CHANGE LIVES (HTCL) MINISTRY, INC.
Entity Type:Organization
Organization Name:HEART TOUCH CHANGE LIVES (HTCL) MINISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:LIGHTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-955-5500
Mailing Address - Street 1:5455 VERNA BLVD UNIT 61446
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-4762
Mailing Address - Country:US
Mailing Address - Phone:904-955-5599
Mailing Address - Fax:
Practice Address - Street 1:5455 VERNA BLVD UNIT 61446
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-4762
Practice Address - Country:US
Practice Address - Phone:904-955-5599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEART TOUCH CHANGE LIVES (HTCL) MINISTRY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty