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General NPI Number Information
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NPI Number | 1629856547
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Entity Type | Organization
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Legal Business Name | HOPE AFTER HEALING
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Dates
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Enumeration Date | 09/20/2023
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 961 W WILLOW GARDEN PASEO
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City | FARMINGTON
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State | UT
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Zip | 84025-3874
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Country | US
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Telephone | 707-280-4448
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Fax |
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Provider Business Mailing Address
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Address Line | 961 W WILLOW GARDEN PASEO
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City | FARMINGTON
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State | UT
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Zip | 84025-3874
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Country | US
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Telephone | 707-280-4448
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LISA L WELLING
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Credential | LCMHC
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Telephone | 707-280-4448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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