Provider Demographics
NPI:1144489071
Name:HEART FOUNDATION
Entity type:Organization
Organization Name:HEART FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAWOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-643-1548
Mailing Address - Street 1:1806 CREIGHTON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-5412
Mailing Address - Country:US
Mailing Address - Phone:804-643-1548
Mailing Address - Fax:804-643-8770
Practice Address - Street 1:1806 CREIGHTON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-5412
Practice Address - Country:US
Practice Address - Phone:804-643-1548
Practice Address - Fax:804-643-8770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty