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General NPI Number Information
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NPI Number | 1154204618
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Entity Type | Organization
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Legal Business Name | HEALING BY CREATIVE DESIGN, INC
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1616 HUNTINGTON ST
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City | LAKELAND
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State | FL
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Zip | 33801-5936
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Country | US
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Telephone | 813-708-9810
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Fax |
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Provider Business Mailing Address
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Address Line | 4798 S FLORIDA AVE # 171
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City | LAKELAND
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State | FL
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Zip | 33813-2181
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Country | US
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Telephone | 813-708-9810
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND EXECUTIVE DIRECTOR
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Name | MR. PAUL AUDIN HENRY
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Credential |
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Telephone | 305-610-2045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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