Healthcare Provider Details

I. General information

NPI: 1548187263
Provider Name (Legal Business Name): ADDICTION HEALING ALLIANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 W VINE ST
NEW WILMINGTON PA
16142-1203
US

IV. Provider business mailing address

145 W VINE ST
NEW WILMINGTON PA
16142-1203
US

V. Phone/Fax

Practice location:
  • Phone: 480-766-8277
  • Fax:
Mailing address:
  • Phone: 480-766-8277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: JAMIE MARIE FARAONE
Title or Position: OWNER
Credential: LICDC
Phone: 480-766-8277