Provider Demographics
NPI:1003835174
Name:FAMILY HEALING CENTER, P.C.
Entity Type:Organization
Organization Name:FAMILY HEALING CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RISHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-524-2851
Mailing Address - Street 1:1401 W FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:AZ
Mailing Address - Zip Code:86025-2218
Mailing Address - Country:US
Mailing Address - Phone:928-524-2851
Mailing Address - Fax:928-524-2171
Practice Address - Street 1:1401 W FLORIDA ST
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:AZ
Practice Address - Zip Code:86025-2218
Practice Address - Country:US
Practice Address - Phone:928-524-2851
Practice Address - Fax:928-524-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ28796Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER