Provider Demographics
NPI:1609472646
Name:HEALING HEART FAMILY THERAPY, INC.
Entity type:Organization
Organization Name:HEALING HEART FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LIZBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGUE
Authorized Official - Suffix:
Authorized Official - Credentials:MS LMFT
Authorized Official - Phone:760-951-2581
Mailing Address - Street 1:13819 AMARGOSA RD SUITE 4
Mailing Address - Street 2:13819 AMARGOSA RD SUITE 4
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392
Mailing Address - Country:US
Mailing Address - Phone:760-951-2581
Mailing Address - Fax:760-951-2888
Practice Address - Street 1:13819 AMARGOSA RD STE 4
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-6405
Practice Address - Country:US
Practice Address - Phone:760-951-2581
Practice Address - Fax:760-951-2888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-06
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health