Provider Demographics
NPI:1124902705
Name:HEALING HEARTS HEALING MINDS LLC
Entity type:Organization
Organization Name:HEALING HEARTS HEALING MINDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVANCED PRACTICE NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:ODETTA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, FNP-BC
Authorized Official - Phone:201-218-7473
Mailing Address - Street 1:969 E LAWN DR
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6604
Mailing Address - Country:US
Mailing Address - Phone:201-218-7473
Mailing Address - Fax:
Practice Address - Street 1:969 E LAWN DR
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-6604
Practice Address - Country:US
Practice Address - Phone:201-936-1315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty