NPIMap

Organization Active NPI

Healing Educational Alternatives for Deserving Students, LLC

  • Community/Behavioral Health Agency
  • Fort Myers, FL
National Provider Identifier
1073871208
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
HEALING EDUCATIONAL ALTERNATIVES FOR DESERVING STUDENTS, LLC
Practice address
3049 Cleveland Ave Ste 290
Fort Myers, FL 33901-7054
Phone
(813) 754-5555
Fax
(813) 754-5552
NPI assigned
Apr 25, 2012
Last updated
Jul 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edward A. Waller Jr., M.ED.NPI 1811387178
Title
Ceo
Phone
(813) 754-5555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3049 Cleveland Ave Ste 290
Fort Myers, FL 33901-7054

Mailing address

1001 E Baker St Ste 100
Plant City, FL 33563-3700
Phone (813) 754-5555

National Provider Directory

National Provider Directory
Tax ID family
Healing Educational Alternatives for Deserving Students LLC Heads19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

3049 Cleveland Ave
Ste 290
Fort Myers, FL 33901
Phone (239) 689-4745

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532649600000",
    "number": "1073871208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E BAKER ST STE 100",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335633700",
            "telephone_number": "813-754-5555",
            "fax_number": "813-754-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3049 CLEVELAND AVE STE 290",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017054",
            "telephone_number": "813-754-5555",
            "fax_number": "813-754-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING EDUCATIONAL ALTERNATIVES FOR DESERVING STUDENTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2018-07-27",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-754-5555",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.