Healthcare Provider Details

I. General information

NPI: 1548387772
Provider Name (Legal Business Name): HEALING HEALTH CENTER OF HAMMOND L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 03/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 E THOMAS ST
HAMMOND LA
70401-2737
US

IV. Provider business mailing address

1004 E THOMAS ST
HAMMOND LA
70401-2737
US

V. Phone/Fax

Practice location:
  • Phone: 985-365-0001
  • Fax:
Mailing address:
  • Phone: 985-365-0001
  • Fax: 985-345-5528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LEIF LLOYD LENSGRAF
Title or Position: C.E.O
Credential: D C
Phone: 985-365-0001