NPIMap

Organization Active NPI

Heads

  • Community/Behavioral Health Agency
  • Lakeland, FL
National Provider Identifier
1851765580
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
IMH13714 Issued in FL
Legal business name
HEADS
Practice address
3244 Merlot Dr
Lakeland, FL 33811-1810
Phone
(863) 614-7771
NPI assigned
Nov 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Authorized official

Name
Ted Wallace, MED
Title
Ceo
Phone
(813) 754-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X IMH13714 FL Primary

Addresses

Primary practice location

3244 Merlot Dr
Lakeland, FL 33811-1810

Mailing address

3244 Merlot Dr
Lakeland, FL 33811-1810
Phone (863) 614-7771

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1851765580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3244 MERLOT DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338111810",
            "telephone_number": "863-614-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3244 MERLOT DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338111810",
            "telephone_number": "863-614-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEADS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-754-5555",
        "authorized_official_credential": "MED"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "IMH13714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.