Provider Demographics
NPI:1245688787
Name:SACRED HEART BEATS
Entity type:Organization
Organization Name:SACRED HEART BEATS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:T
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MT, DT
Authorized Official - Phone:864-934-8406
Mailing Address - Street 1:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29677-0208
Mailing Address - Country:US
Mailing Address - Phone:864-934-8406
Mailing Address - Fax:
Practice Address - Street 1:1107 WATKINS ROAD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625
Practice Address - Country:US
Practice Address - Phone:864-934-8406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty