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General NPI Number Information
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NPI Number | 1093326811
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Entity Type | Organization
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Legal Business Name | HEALING HEARTS TO RESILIENCY
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Dates
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Enumeration Date | 08/14/2020
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Last Update Date | 08/14/2020
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Provider Practice Location Address
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Address Line | 125 SEXTON DR
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City | HONORAVILLE
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State | AL
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Zip | 36042-3624
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Country | US
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Telephone | 800-484-4107
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Fax | 800-484-4107
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Provider Business Mailing Address
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Address Line | PO BOX 115
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City | HIGHLAND HOME
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State | AL
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Zip | 36041-0115
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Country | US
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Telephone | 334-320-1449
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Fax |
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Authorized Official
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Title or Position | VP
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Name | DR. TI'ONYA M GREEN
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Credential | PHD
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Telephone | 856-375-0018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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