Healthcare Provider Details

I. General information

NPI: 1144196569
Provider Name (Legal Business Name): THE HEALING NEST NC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8365 MCGUIRE DR
RALEIGH NC
27616-5683
US

IV. Provider business mailing address

2806 COURTHOUSE RD
HOPEWELL VA
23860-5912
US

V. Phone/Fax

Practice location:
  • Phone: 804-414-5799
  • Fax:
Mailing address:
  • Phone: 804-414-5799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. OSCAR BYRD
Title or Position: MANAGER
Credential:
Phone: 804-414-5799