Provider Demographics
NPI:1255455002
Name:HEARTFIELD HOME FOR BOYS, INC.
Entity type:Organization
Organization Name:HEARTFIELD HOME FOR BOYS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:PORTER
Authorized Official - Last Name:COLES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-795-9191
Mailing Address - Street 1:3815 PHEASANT HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-7583
Mailing Address - Country:US
Mailing Address - Phone:804-795-9191
Mailing Address - Fax:
Practice Address - Street 1:3815 PHEASANT HOLLOW DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-7583
Practice Address - Country:US
Practice Address - Phone:804-795-9191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA87214001322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children