MEDICARE: HEALING ADULTS & ADOLESCENTS RESIDENTIAL TREATMENT PROGRAM LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1619741147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING ADULTS & ADOLESCENTS RESIDENTIAL TREATMENT PROGRAM LLC

Provider Business Mailing Address
First Line	:	790 OLD PORTER RD
Second Line	:
City	:	BEAR
State	:	DE
Zip	:	19701-1835
Country	:	US
Telephone Number	:	302-521-9898
Fax Number	:

Provider Business Practice Location Address
First Line	:	790 OLD PORTER RD
Second Line	:
City	:	BEAR
State	:	DE
Zip	:	19701-1835
Country	:	US
Telephone Number	:	302-521-9898
Fax Number	:

Authorized Official
Title or Position	:	SCHOOL PSYCHOLOGIST
Name	:	SHERYL ANN HERBERT
Credential	:
Telephone Number	:	302-521-9898

Provider Enumeration Date	:	11/15/2023
Last Update Date	:	03/12/2025

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