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Organization
HEALING EDUCATIONAL ALTERNATIVES FOR DESERVING STUDENTS
Active
Organization
HEALING EDUCATIONAL ALTERNATIVES FOR DESERVING STUDENTS
Active
Other names
HEADS
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD A WALLER M.ED (COO)
(813) 754-5555
Entity
Organization
Contact information
Practice address
50 N LAURA ST, SUITE 2500, JACKSONVILLE, FL 32202-3664
(813) 754-5555
(813) 754-5552
Mailing address
1001 E BAKER ST, SUITE 202, PLANT CITY, FL 33563-3700
(813) 754-5555
(813) 754-5552
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
05
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006323200
—
FL
05
—
007813200
—
FL
05
—
007862400
—
FL
01
—
1053658153
NPI- ORLANDO LOCATION
FL
01
—
1073871208
NPI- FORT MYERS LOCATION
FL
01
—
1326311085
NPI TAMPA LOCATION
FL
Enumeration date
09/11/2014
Last updated
09/11/2014
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