Provider Demographics
NPI:1750149357
Name:HEARTDLY HEARD
Entity type:Organization
Organization Name:HEARTDLY HEARD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RCM
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-250-8989
Mailing Address - Street 1:151 KALMUS DR STE A203
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5999
Mailing Address - Country:US
Mailing Address - Phone:714-330-7312
Mailing Address - Fax:
Practice Address - Street 1:8780 WARNER AVE STE 11
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3210
Practice Address - Country:US
Practice Address - Phone:714-330-7312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder