Provider Demographics
NPI:1922513688
Name:HEALING HEARTS HEALING LIVES LLC
Entity Type:Organization
Organization Name:HEALING HEARTS HEALING LIVES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALARRAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-903-3253
Mailing Address - Street 1:25 KILMARTIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716-1210
Mailing Address - Country:US
Mailing Address - Phone:203-903-3253
Mailing Address - Fax:203-439-2087
Practice Address - Street 1:304 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2985
Practice Address - Country:US
Practice Address - Phone:203-903-3253
Practice Address - Fax:203-439-2087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty