Healthcare Provider Details

I. General information

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

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 04/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 BROWNING ST SW
ATLANTA GA
30314-2204
US

IV. Provider business mailing address

PO BOX 2033
LITHONIA GA
30058-1039
US

V. Phone/Fax

Practice location:
  • Phone: 404-289-5277
  • Fax: 404-890-5644
Mailing address:
  • Phone: 404-289-5277
  • Fax: 404-890-5644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. BONITA LACY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 404-289-5277