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General NPI Number Information
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NPI Number | 1962937888
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Entity Type | Organization
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Legal Business Name | HEALING ARTS INSTITUTE OF SOUTH FLORIDA INTERNATIONAL INC.
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 04/25/2019
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Provider Practice Location Address
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Address Line | 4699 N STATE ROAD 7 STE B1
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-5870
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Country | US
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Telephone | 954-459-1473
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Fax | 954-982-2799
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Provider Business Mailing Address
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Address Line | 4699 N STATE ROAD 7 STE B1
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-5870
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Country | US
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Telephone | 954-459-1473
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Fax | 954-982-2799
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Authorized Official
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Title or Position | CEO
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Name | DR. THELMA ELIZABETH TENNIE
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Credential | PHD
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Telephone | 954-459-1473
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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 | N15000007106
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License Number State | FL
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