| Healing Hearts Therapeutic Services, Inc | |
|
824 Gum Branch Rd Ste E Jacksonville NC 28540-6269 | |
| (910) 347-1694 | |
| (910) 347-3691 |
| Full Name | Healing Hearts Therapeutic Services, Inc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 824 Gum Branch Rd Ste E, Jacksonville, North Carolina |
| Authorized Official Name and Position | Demetrious Shepard (CEO CLINICAL DIRECTOR) |
| Authorized Official Contact | 9103471694 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Hearts Therapeutic Services, Inc 824 Gum Branch Rd Ste E Jacksonville NC 28540-6269 Ph: (910) 347-1694 | Healing Hearts Therapeutic Services, Inc 824 Gum Branch Rd Ste E Jacksonville NC 28540-6269 Ph: (910) 347-1694 |
| NPI Number | 1053498683 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 07/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053498683 | NPI | - | NPPES |
| 6005845 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
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