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General NPI Number Information
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NPI Number | 1124963947
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Entity Type | Organization
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Legal Business Name | HEALING CENTER COMMUNITY CARE LLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 536 45TH ST S APT 202
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City | FARGO
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State | ND
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Zip | 58103-0903
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Country | US
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Telephone | 701-540-1191
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Fax |
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Provider Business Mailing Address
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Address Line | 536 45TH ST S APT 202
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City | FARGO
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State | ND
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Zip | 58103-0903
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Country | US
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Telephone | 701-540-1191
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KHALIYAH MARSHALL
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Credential |
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Telephone | 701-540-1191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WR0400X
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Taxonomy Name | Rehabilitation Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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