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General NPI Number Information
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NPI Number | 1922821701
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Entity Type | Organization
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Legal Business Name | HEALING HOMES
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 2915 FRANKFORT AVE STE 1
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City | LOUISVILLE
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State | KY
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Zip | 40206-2682
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Country | US
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Telephone | 502-912-2491
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Fax |
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Provider Business Mailing Address
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Address Line | 2915 FRANKFORT AVE STE 1
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City | LOUISVILLE
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State | KY
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Zip | 40206-2682
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Country | US
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Telephone | 502-912-2491
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Fax |
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Authorized Official
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Title or Position | BILLER/CREDENTIALER
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Name | STEPHANIE GAIL HALL
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Credential |
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Telephone | 502-774-0671
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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 |
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License Number State |
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