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General NPI Number Information
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NPI Number | 1720852965
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Entity Type | Organization
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Legal Business Name | HEALING HORIZONS BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 11/08/2023
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 651 GRAND PANAMA BLVD STE B1-103
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-3458
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Country | US
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Telephone | 850-850-6019
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Fax | 850-850-6029
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Provider Business Mailing Address
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Address Line | PO BOX 27360
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City | PANAMA CITY
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State | FL
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Zip | 32411-7360
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Country | US
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Telephone | 850-850-6019
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Fax | 850-850-6029
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | HINA SMITH
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Credential | MD
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Telephone | 850-850-6019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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