Provider Demographics
NPI:1669257648
Name:HEALING PAYNE
Entity type:Organization
Organization Name:HEALING PAYNE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:ICADC, SAP, HS-BCP,
Authorized Official - Phone:904-472-5310
Mailing Address - Street 1:PO BOX 60302
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32236-0302
Mailing Address - Country:US
Mailing Address - Phone:904-577-0195
Mailing Address - Fax:902-212-2596
Practice Address - Street 1:8166 HOMESTEAD OAKS DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-1600
Practice Address - Country:US
Practice Address - Phone:904-577-0195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children