Provider Demographics
NPI:1114739356
Name:HEALING HEARTS MEDICAL
Entity type:Organization
Organization Name:HEALING HEARTS MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAKISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS-MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-243-0414
Mailing Address - Street 1:2322 KIRKSTALL WAY
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-3678
Mailing Address - Country:US
Mailing Address - Phone:228-243-0414
Mailing Address - Fax:
Practice Address - Street 1:10935 ESTATE LN STE S132
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2316
Practice Address - Country:US
Practice Address - Phone:214-584-6359
Practice Address - Fax:214-380-5227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-24
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care