MEDICARE: H.E.R.S. ALLIANCES & ENTERPRISE INC

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	101YM0800X	Mental Health Counselor
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1811737349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H.E.R.S. ALLIANCES & ENTERPRISE INC

Provider Business Mailing Address
First Line	:	2013 NW 12TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-3607
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2013 NW 12TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-3607
Country	:	US
Telephone Number	:	770-896-9453
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ALTHEA WEBB
Credential	:
Telephone Number	:	770-896-9453

Provider Enumeration Date	:	05/31/2024
Last Update Date	:	05/31/2024

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