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General NPI Number Information
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NPI Number | 1649715590
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Entity Type | Organization
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Legal Business Name | RESTORING THE HEART
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Dates
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Enumeration Date | 01/02/2017
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Last Update Date | 01/02/2017
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Provider Practice Location Address
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Address Line | 6601 STORM CAT LN
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City | BURLESON
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State | TX
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Zip | 76028-7963
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Country | US
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Telephone | 817-229-9316
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Fax | 817-551-3744
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Provider Business Mailing Address
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Address Line | PO BOX 3284
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City | BURLESON
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State | TX
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Zip | 76097-3284
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Country | US
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Telephone | 817-229-9316
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Fax | 817-551-3744
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Authorized Official
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Title or Position | CEO
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Name | MRS. DEWANDA HARRIS TRIMIAR
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Credential |
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Telephone | 817-229-9316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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