Provider Demographics
NPI:1588437248
Name:HEALING HEARTS SERVICES LLC
Entity type:Organization
Organization Name:HEALING HEARTS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:WOODEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:804-338-9475
Mailing Address - Street 1:5105 FORT SUMTER RD # 4S
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2384
Mailing Address - Country:US
Mailing Address - Phone:804-338-9475
Mailing Address - Fax:
Practice Address - Street 1:4111 ROSE LAKE DR # 6264
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-2829
Practice Address - Country:US
Practice Address - Phone:888-462-3453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care