Healthcare Provider Details

I. General information

NPI: 1780293563
Provider Name (Legal Business Name): HEARD ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W OCEAN BLVD STE 400
LONG BEACH CA
90802-4633
US

IV. Provider business mailing address

111 W OCEAN BLVD STE 400
LONG BEACH CA
90802-4633
US

V. Phone/Fax

Practice location:
  • Phone: 323-208-2040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ERA THOMPSON
Title or Position: CEO
Credential:
Phone: 323-208-2040