Provider Demographics
NPI:1184967077
Name:HEALING HEARTS LLC
Entity type:Organization
Organization Name:HEALING HEARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MSW-MHRT/C
Authorized Official - Phone:207-492-1000
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-0087
Mailing Address - Country:US
Mailing Address - Phone:207-492-1000
Mailing Address - Fax:207-492-1006
Practice Address - Street 1:7 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-2456
Practice Address - Country:US
Practice Address - Phone:207-492-1000
Practice Address - Fax:207-492-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME661053101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty