Provider Demographics
NPI:1922417088
Name:HEARTSTRINGS PREGNANCY AND INFANT LOSS SUPPORT, INC.
Entity Type:Organization
Organization Name:HEARTSTRINGS PREGNANCY AND INFANT LOSS SUPPORT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-681-1791
Mailing Address - Street 1:PO BOX 10825
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27404-0825
Mailing Address - Country:US
Mailing Address - Phone:336-335-9931
Mailing Address - Fax:
Practice Address - Street 1:233 W MOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-2529
Practice Address - Country:US
Practice Address - Phone:336-333-2559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-03
Last Update Date:2014-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health