Provider Demographics
NPI:1366120487
Name:MA HILAS HEART PROJECT FOUNDATION
Entity type:Organization
Organization Name:MA HILAS HEART PROJECT FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:CANTU
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, LCDC, LPC
Authorized Official - Phone:210-834-5017
Mailing Address - Street 1:8426 FOUNTAIN CIR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2387
Mailing Address - Country:US
Mailing Address - Phone:210-281-5997
Mailing Address - Fax:
Practice Address - Street 1:8426 FOUNTAIN CIR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2387
Practice Address - Country:US
Practice Address - Phone:210-281-5997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty