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General NPI Number Information
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NPI Number | 1972975225
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Entity Type | Organization
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Legal Business Name | HEALING LIFE HEALTH CENTER LLC
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 2410 FERRAND ST STE 9&10
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City | MONROE
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State | LA
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Zip | 71201-3242
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Country | US
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Telephone | 318-323-1560
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Fax | 318-323-5682
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Provider Business Mailing Address
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Address Line | PO BOX 1497
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City | BASTROP
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State | LA
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Zip | 71221-1497
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Country | US
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Telephone | 318-450-2300
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Fax | 318-283-0210
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Authorized Official
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Title or Position | OWNER
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Name | MR. HENRY HARRIS JR.
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Credential |
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Telephone | 318-450-2300
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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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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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