Provider Demographics
NPI:1770061962
Name:HEALING HEARTS THERAPY LLC
Entity type:Organization
Organization Name:HEALING HEARTS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DEMOINES
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:810-471-7065
Mailing Address - Street 1:11625 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:MI
Mailing Address - Zip Code:48458-2016
Mailing Address - Country:US
Mailing Address - Phone:810-471-7065
Mailing Address - Fax:
Practice Address - Street 1:11625 CHURCH ST
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:MI
Practice Address - Zip Code:48458-2016
Practice Address - Country:US
Practice Address - Phone:810-471-7065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty