MEDICARE: HEAVENLY CHRISTIAN ACADEMY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1033073051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAVENLY CHRISTIAN ACADEMY

Provider Business Mailing Address
First Line	:	11421 SHILOH RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-2150
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11421 SHILOH RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-2150
Country	:	US
Telephone Number	:	972-681-7545
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TIA BATISTE
Credential	:
Telephone Number	:	214-448-5443

Provider Enumeration Date	:	12/13/2025
Last Update Date	:	12/19/2025

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Directions to “HEAVENLY CHRISTIAN ACADEMY ” Practice Location

Language	Start Address	Practice Location

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