Healthcare Provider Details

I. General information

NPI: 1053226936
Provider Name (Legal Business Name): HEALING HEARTZ DAILY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 SALEM CHURCH RD
CARROLLTON GA
30117-9622
US

IV. Provider business mailing address

129 GARDEN RIDGE DR
CARROLLTON GA
30116-5416
US

V. Phone/Fax

Practice location:
  • Phone: 561-914-7155
  • Fax:
Mailing address:
  • Phone: 561-914-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: AMBER NICHOLSON
Title or Position: OWNER
Credential:
Phone: 561-914-7155