Provider Demographics
NPI:1902353766
Name:HEART 2 HEART WELLNESS, LLC
Entity Type:Organization
Organization Name:HEART 2 HEART WELLNESS, LLC
Other - Org Name:HEART 2 HEART WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLYNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-608-0850
Mailing Address - Street 1:1919 STATE ST
Mailing Address - Street 2:SUITE 18
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-4929
Mailing Address - Country:US
Mailing Address - Phone:502-608-0850
Mailing Address - Fax:
Practice Address - Street 1:1919 STATE ST
Practice Address - Street 2:SUITE 18
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4929
Practice Address - Country:US
Practice Address - Phone:502-608-0850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006576A1041C0700X
KY38371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty