Provider Demographics
NPI:1922821701
Name:HEALING HOMES
Entity type:Organization
Organization Name:HEALING HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER/CREDENTIALER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-774-0671
Mailing Address - Street 1:2915 FRANKFORT AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2682
Mailing Address - Country:US
Mailing Address - Phone:502-912-2491
Mailing Address - Fax:
Practice Address - Street 1:2915 FRANKFORT AVE STE 1
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-2682
Practice Address - Country:US
Practice Address - Phone:502-912-2491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health