Provider Demographics
NPI:1194259762
Name:HEART MATTERS, LLC
Entity type:Organization
Organization Name:HEART MATTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:CHANIELLE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-875-9756
Mailing Address - Street 1:PO BOX 743
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203
Mailing Address - Country:US
Mailing Address - Phone:908-875-9756
Mailing Address - Fax:
Practice Address - Street 1:500 1-2 EAST FIRST AVENUE
Practice Address - Street 2:UNIT 1 RIGHT
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203
Practice Address - Country:US
Practice Address - Phone:908-875-9756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC000347500101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty