Healthcare Provider Details

I. General information

NPI: 1013715176
Provider Name (Legal Business Name): HEARTS CONNECTED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2634 RANGEWOOD CT NE
ATLANTA GA
30345-1509
US

IV. Provider business mailing address

2634 RANGEWOOD CT NE
ATLANTA GA
30345-1509
US

V. Phone/Fax

Practice location:
  • Phone: 404-516-0906
  • Fax: 404-516-0906
Mailing address:
  • Phone: 404-516-0906
  • Fax: 404-516-0906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: DEBRA DUPREY FRITCH
Title or Position: CEO
Credential: RN
Phone: 404-516-0906