Provider Demographics
NPI:1487425658
Name:HEALING HAVEN
Entity type:Organization
Organization Name:HEALING HAVEN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:HARRY
Authorized Official - Last Name:CAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:831-359-4223
Mailing Address - Street 1:550 WATER ST STE C3
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-4128
Mailing Address - Country:US
Mailing Address - Phone:831-359-4223
Mailing Address - Fax:831-603-7054
Practice Address - Street 1:550 WATER ST STE C3
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4128
Practice Address - Country:US
Practice Address - Phone:831-359-4223
Practice Address - Fax:831-603-7054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty