Provider Demographics
NPI:1285105825
Name:HEALING HEARTS THERAPEUTIC SERVICES CENTER
Entity type:Organization
Organization Name:HEALING HEARTS THERAPEUTIC SERVICES CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:THOMPKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:702-461-8023
Mailing Address - Street 1:1654 MARATHON DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-2726
Mailing Address - Country:US
Mailing Address - Phone:702-461-8023
Mailing Address - Fax:
Practice Address - Street 1:1654 MARATHON DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-2726
Practice Address - Country:US
Practice Address - Phone:702-461-8023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-07
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health