CMS-1500 Box 24J / 33a • NPI
1083362768
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
322D00000X
Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children
Box 32 Service Location & ZIP+4
1613 GREENDALE CT, FORT WORTH, TX, 76112-3410
✓ 9-Digit EDI 837 ZIP+4 (76112-3410)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1083362768 (4HEALING HEARTS INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1083362768 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | 4HEALING HEARTS INC |
| Plain-English Specialty | Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children NUCC Code: 322D00000X (Residential Treatment Facility, Emotionally Disturbed Children) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1613 GREENDALE CT, FORT WORTH, TX, 76112-3410 |
| Practice Telephone / Fax | Tel: (817) 680-7912 | Fax: (817) 887-2415 |
| Administrative Mailing Address | PO BOX 8006, FORT WORTH, TX, 76124-0006 |
| Enumeration & Last Sync | Enumerated: 2022-03-12 | CMS Record Updated: 2022-03-12 |
| Authorized Official | TYIESHA BROWN (Administrator) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (322D00000X)
What Does Taxonomy Code 322D00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 322D00000X translates to:
"Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (4HEALING HEARTS INC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
251B00000X — Case ManagementPlain English: Licensed & Credentialed Case Management | State: N/A | License: Verified | Primary: Secondary |
253J00000X — Foster Care AgencyPlain English: Licensed & Credentialed Foster Care Agency | State: N/A | License: Verified | Primary: Secondary |
261QM0855X — Clinic/Center, Adolescent and Children Mental HealthPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Secondary |
1041C0700X — Social Worker, ClinicalPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical | State: N/A | License: Verified | Primary: Secondary |
322D00000X — Residential Treatment Facility, Emotionally Disturbed ChildrenPlain English: Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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