Provider Demographics
NPI:1174122014
Name:HEARTBEAT THERAPY, INC
Entity type:Organization
Organization Name:HEARTBEAT THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:D'ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-799-6812
Mailing Address - Street 1:302 CUMBERLAND WAY SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-7766
Mailing Address - Country:US
Mailing Address - Phone:470-371-8308
Mailing Address - Fax:
Practice Address - Street 1:2400 HERODIAN WAY SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-8581
Practice Address - Country:US
Practice Address - Phone:770-799-6812
Practice Address - Fax:844-710-7947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)