MEDICARE: HEALING INTEGRATED HEALTH CENTER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1417839721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING INTEGRATED HEALTH CENTER, INC

Provider Business Mailing Address
First Line	:	1010 E MCDOWELL RD STE 102
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2607
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 E MCDOWELL RD STE 102
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2607
Country	:	US
Telephone Number	:	602-446-1625
Fax Number	:

Authorized Official
Title or Position	:	CEO/DIRECTOR
Name	:	KODJO WELBECK
Credential	:
Telephone Number	:	602-446-1625

Provider Enumeration Date	:	07/25/2025
Last Update Date	:	03/23/2026

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