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General NPI Number Information
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NPI Number | 1881040319
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Entity Type | Organization
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Legal Business Name | HEALING FOR MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 05/31/2016
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Provider Practice Location Address
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Address Line | 41 IROQUOIS AVE
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City | LAKE HIAWATHA
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State | NJ
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Zip | 07034-2305
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Country | US
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Telephone | 973-615-3712
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Fax |
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Provider Business Mailing Address
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Address Line | 41 IROQUOIS AVE
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City | LAKE HIAWATHA
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State | NJ
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Zip | 07034-2305
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Country | US
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Telephone | 973-615-3712
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER/MANAGER
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Name | DESIREE TEMPANY
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Credential |
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Telephone | 973-615-3712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 37PC00499100
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License Number State | NJ
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