1871096370 NPI number — HEARTS-IN-HEALING THERAPY, LLC

Table of content: (NPI 1871096370)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871096370 NPI number — HEARTS-IN-HEALING THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEARTS-IN-HEALING THERAPY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MARIA AMELIA MENOZZI
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871096370
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23409 JEFFERSON AVE STE 100B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT CLAIR SHORES
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48080-3449
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-777-3132
Provider Business Mailing Address Fax Number:
248-633-8829

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23409 JEFFERSON AVE STE 100B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT CLAIR SHORES
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48080-3449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-777-3132
Provider Business Practice Location Address Fax Number:
248-633-8829
Provider Enumeration Date:
03/12/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MENOZZI
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
AMELIA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
586-777-3132

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  C-02929 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 4101006595 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)