MEDICARE: HEALING HEARTS MEDICAL, 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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1811841075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HEARTS MEDICAL, LLC

Provider Business Mailing Address
First Line	:	10935 ESTATE LN STE S132
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75238-2316
Country	:	US
Telephone Number	:	214-584-6359
Fax Number	:	214-380-5227

Provider Business Practice Location Address
First Line	:	10935 ESTATE LN STE S132
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75238-2316
Country	:	US
Telephone Number	:	214-584-6359
Fax Number	:	214-380-5227

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LAKISHA COLLINS-MITCHELL
Credential	:
Telephone Number	:	228-243-0414

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

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