Provider Demographics
NPI:1649715590
Name:RESTORING THE HEART
Entity type:Organization
Organization Name:RESTORING THE HEART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEWANDA
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:TRIMIAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-229-9316
Mailing Address - Street 1:PO BOX 3284
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76097-3284
Mailing Address - Country:US
Mailing Address - Phone:817-229-9316
Mailing Address - Fax:817-551-3744
Practice Address - Street 1:6601 STORM CAT LN
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7963
Practice Address - Country:US
Practice Address - Phone:817-229-9316
Practice Address - Fax:817-551-3744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX501 (C)(3)OtherNON PROFIT