MEDICARE: HEALING HEARTS OF FAMILIES USA MINISTRIES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	324500000X	Substance Abuse Rehabilitation Facility
2	251V00000X	Voluntary or Charitable Agency
3	251S00000X	Community/Behavioral Health Agency
4	251E00000X	Home Health Agency
5	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1386842920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HEARTS OF FAMILIES USA MINISTRIES, INC

Provider Business Mailing Address
First Line	:	PO BOX 2033
Second Line	:
City	:	LITHONIA
State	:	GA
Zip	:	30058-1039
Country	:	US
Telephone Number	:	404-289-5277
Fax Number	:	404-890-5644

Provider Business Practice Location Address
First Line	:	1712 BROWNING ST SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30314-2204
Country	:	US
Telephone Number	:	404-289-5277
Fax Number	:	404-890-5644

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. BONITA LACY
Credential	:
Telephone Number	:	404-289-5277

Provider Enumeration Date	:	07/05/2007
Last Update Date	:	04/08/2011

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