Provider Demographics
NPI:1306686357
Name:HEARTBEAT RT-LLC
Entity type:Organization
Organization Name:HEARTBEAT RT-LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RECREATION THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KYWANA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:LRT, CTRS
Authorized Official - Phone:910-515-3492
Mailing Address - Street 1:2400 ALSTONBURG AVE
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9384
Mailing Address - Country:US
Mailing Address - Phone:910-515-3492
Mailing Address - Fax:
Practice Address - Street 1:2400 ALSTONBURG AVE
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-9384
Practice Address - Country:US
Practice Address - Phone:910-515-3492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty