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General NPI Number Information
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NPI Number | 1083582704
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Entity Type | Organization
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Legal Business Name | HEAL EXPERIENTIAL LLC
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Dates
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Enumeration Date | 10/24/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 575 WHITE AVE
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City | WEED
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State | CA
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Zip | 96094-2431
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Country | US
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Telephone | 530-598-9728
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Fax |
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Provider Business Mailing Address
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Address Line | 404 S MAIN ST # 128
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City | YREKA
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State | CA
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Zip | 96097-3023
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Country | US
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Telephone | 530-598-9728
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Fax | 530-842-7917
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Authorized Official
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Title or Position | CEO
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Name | MR. JUDD ANTHONY PINDELL
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Credential |
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Telephone | 530-598-9728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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