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General NPI Number Information
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NPI Number | 1568109742
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Entity Type | Organization
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Legal Business Name | THE HEALING CENTER INC
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 444 HOSPITAL WAY STE 422
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City | POCATELLO
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State | ID
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Zip | 83201-2744
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Country | US
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Telephone | 208-557-9450
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Fax | 208-561-7111
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Provider Business Mailing Address
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Address Line | 444 HOSPITAL WAY STE 422
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City | POCATELLO
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State | ID
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Zip | 83201-2744
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Country | US
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Telephone | 208-557-9450
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Fax | 208-561-7111
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Authorized Official
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Title or Position | OWNER/BUSINESS ADMINISTRATOR
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Name | MICHAEL JON MENDENHALL
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Credential | AS
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Telephone | 208-557-9450
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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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