=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760797922
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALING ARTS & WELLNESS CENTERS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2010
-----------------------------------------------------
Last Update Date | 08/12/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 410 EVERNIA ST 315
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33401-5430
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-685-8280
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 410 EVERNIA STREET 315
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33401-0000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-685-8280
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ DIRECTOR
-----------------------------------------------------
Name | DR. ADRIANO ROJAS
-----------------------------------------------------
Credential | PSY. D., L.M.H.C.
-----------------------------------------------------
Telephone | 561-685-8280
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | MH8340
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------