Hearted Rejuvenation LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

HEARTED REJUVENATION LLC

Practice address

3175 County Road 2606
Caddo Mills, TX 75135-6269

Phone

(469) 348-5488

NPI assigned

Jun 29, 2021

Last updated

Jun 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sylvia Chingaya

Title

Ceo

Phone

(469) 348-5488

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1821668054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 COUNTY ROAD 2606",
            "city": "CADDO MILLS",
            "state": "TX",
            "postal_code": "751356269",
            "telephone_number": "469-348-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 COUNTY ROAD 2606",
            "city": "CADDO MILLS",
            "state": "TX",
            "postal_code": "751356269",
            "telephone_number": "469-348-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTED REJUVENATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "CHINGAYA",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-348-5488"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wendy Kemp
• Shannon Kelly Kennedy, FNP-C

• Mental Illness Community Based Residential Treatment Facility in Caddo Mills, TX
• Providers in Caddo Mills, TX by specialty
• Mental Illness Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.