Healthcare Provider Details

I. General information

NPI: 1124826201
Provider Name (Legal Business Name): HEROES RING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 WYNNEWOOD RD
PHILADELPHIA PA
19151-3820
US

IV. Provider business mailing address

747 WYNNEWOOD RD
PHILADELPHIA PA
19151-3820
US

V. Phone/Fax

Practice location:
  • Phone: 267-506-5936
  • Fax:
Mailing address:
  • Phone: 267-506-5936
  • Fax: 267-506-5936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARCE Y GARBETT- RINGGOLD
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MHS,MS
Phone: 267-506-5936