Provider Demographics
NPI:1689310328
Name:HEALING HEARTS OF AMERICA, INC
Entity Type:Organization
Organization Name:HEALING HEARTS OF AMERICA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:CONSTANCE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-697-5598
Mailing Address - Street 1:3148 RAVENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1644
Mailing Address - Country:US
Mailing Address - Phone:602-697-5598
Mailing Address - Fax:
Practice Address - Street 1:3148 RAVENWOOD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1644
Practice Address - Country:US
Practice Address - Phone:602-697-5598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management