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General NPI Number Information
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NPI Number | 1356959191
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Entity Type | Organization
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Legal Business Name | HEALING MINDS LLC
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 8382 N WAYNE DR STE 103B
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City | HAYDEN
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State | ID
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Zip | 83835-6028
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Country | US
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Telephone | 208-819-5415
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Fax | 208-203-1496
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Provider Business Mailing Address
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Address Line | 6586 W FLAGSTAFF ST
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City | RATHDRUM
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State | ID
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Zip | 83858-8203
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Country | US
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Telephone | 208-819-5415
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CINDY FREER
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Credential | LCSW
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Telephone | 208-819-5415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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