Healthcare Provider Details

I. General information

NPI: 1497625206
Provider Name (Legal Business Name): THE HEALING SANCTUARY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3621 MATTOX ST
EL PASO TX
79925-1307
US

IV. Provider business mailing address

2000 GLEMMWAY PL
EL PASO TX
79925-6828
US

V. Phone/Fax

Practice location:
  • Phone: 915-996-2776
  • Fax:
Mailing address:
  • Phone: 915-996-2776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALYSSA GARY
Title or Position: OWNER
Credential: CTRS
Phone: 575-520-5166