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General NPI Number Information
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NPI Number | 1427878776
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Entity Type | Organization
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Legal Business Name | HEALING INSPIRED BEHAVIORAL SERVICES LLC
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 1945 PHILLIPS AVE
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City | RACINE
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State | WI
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Zip | 53403-2547
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Country | US
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Telephone | 262-321-9297
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 PHILLIPS AVE
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City | RACINE
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State | WI
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Zip | 53403-2547
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Country | US
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Telephone | 262-321-9297
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELONIE L CAMPBELL
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Credential |
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Telephone | 262-321-9297
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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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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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