Healthcare Provider Details
I. General information
NPI: 1962068726
Provider Name (Legal Business Name): HEARTS N MINDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2019
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
44 SADDLE WAY
CHESTERFIELD NJ
08515-2920
US
IV. Provider business mailing address
44 SADDLE WAY
CHESTERFIELD NJ
08515-2920
US
V. Phone/Fax
- Phone: 609-622-9559
- Fax:
- Phone: 609-622-9559
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ANTONIO
EUGENE
DELGADO
Title or Position: PRESIDENT/CEO
Credential: MBA
Phone: 609-622-9559