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General NPI Number Information
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NPI Number | 1497490155
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Entity Type | Organization
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Legal Business Name | ZION HEALING CENTER SO-CAL
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 330 S MAGNOLIA AVE STE 203
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City | EL CAJON
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State | CA
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Zip | 92020-5224
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Country | US
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Telephone | 435-319-0351
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Fax |
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Provider Business Mailing Address
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Address Line | 158 N 240 E
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City | HURRICANE
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State | UT
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Zip | 84737-1380
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Country | US
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Telephone | 435-319-0351
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Fax |
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | GREYDEN JOSEF HEDBERG
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Credential |
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Telephone | 435-319-0351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 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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