Healthcare Provider Details
I. General information
NPI: 1780342634
Provider Name (Legal Business Name): HARMONIOUS HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/07/2021
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6022 WELDON SPRING PKWY
WELDON SPRING MO
63304-9103
US
IV. Provider business mailing address
6022 WELDON SPRING PKWY
WELDON SPRING MO
63304-9103
US
V. Phone/Fax
- Phone: 636-324-3388
- Fax:
- Phone: 636-324-3388
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ZHANNA
A
KEETON
Title or Position: CEO
Credential: MBA, LPC
Phone: 636-324-3388