Provider Demographics
NPI:1649545005
Name:OUR HEART 2 YOURS COUNSELING SERVICE
Entity type:Organization
Organization Name:OUR HEART 2 YOURS COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MA,BS
Authorized Official - Phone:407-347-2092
Mailing Address - Street 1:410 N DILLARD ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2853
Mailing Address - Country:US
Mailing Address - Phone:407-347-2092
Mailing Address - Fax:407-347-2093
Practice Address - Street 1:410 N DILLARD ST
Practice Address - Street 2:SUITE 104
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-2853
Practice Address - Country:US
Practice Address - Phone:407-347-2092
Practice Address - Fax:407-347-2093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health