Provider Demographics
NPI:1932255924
Name:HEALS, INC.
Entity Type:Organization
Organization Name:HEALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:CARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-428-7560
Mailing Address - Street 1:1100 MERIDIAN ST N
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4636
Mailing Address - Country:US
Mailing Address - Phone:256-428-7560
Mailing Address - Fax:256-428-7561
Practice Address - Street 1:3112 MERIDIAN ST N
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-1539
Practice Address - Country:US
Practice Address - Phone:256-428-7110
Practice Address - Fax:256-428-7111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL32891223G0001X
ALAL37391223G0001X
ALAL54521223G0001X
ALAL51761223G0001X
ALAL22181223G0001X
ALAL36731223G0001X
ALAL26211223G0001X
ALAL52181223G0001X
ALAL25051223P0221X
ALAL26711223P0221X
ALAL25581223P0221X
ALAL39651223P0300X
208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529907450Medicaid