Provider Demographics
NPI:1073164315
Name:HEALING PATH WELLNESS LLC
Entity Type:Organization
Organization Name:HEALING PATH WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:912-572-7585
Mailing Address - Street 1:2126 E VICTORY DR # 110
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-3918
Mailing Address - Country:US
Mailing Address - Phone:912-231-5251
Mailing Address - Fax:
Practice Address - Street 1:7505 WATERS AVE STE C5
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3820
Practice Address - Country:US
Practice Address - Phone:912-231-5251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-27
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)