Provider Demographics
NPI:1790496669
Name:HEALING HEARTS MINISTRIES
Entity Type:Organization
Organization Name:HEALING HEARTS MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:STAEBELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT & LMHC
Authorized Official - Phone:850-624-8626
Mailing Address - Street 1:2624 GREENHEAD RD
Mailing Address - Street 2:
Mailing Address - City:CHIPLEY
Mailing Address - State:FL
Mailing Address - Zip Code:32428-6512
Mailing Address - Country:US
Mailing Address - Phone:850-624-8626
Mailing Address - Fax:
Practice Address - Street 1:2624 GREENHEAD RD
Practice Address - Street 2:
Practice Address - City:CHIPLEY
Practice Address - State:FL
Practice Address - Zip Code:32428-6512
Practice Address - Country:US
Practice Address - Phone:850-624-8626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No282J00000XHospitalsReligious Nonmedical Health Care Institution