Provider Demographics
NPI:1093249393
Name:HEALING FOR ALL LLC
Entity Type:Organization
Organization Name:HEALING FOR ALL LLC
Other - Org Name:SHERRI M BROADWATER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BROADWATER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-646-3349
Mailing Address - Street 1:3307 SIR HENRY ST
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-5831
Mailing Address - Country:US
Mailing Address - Phone:832-646-3349
Mailing Address - Fax:423-822-5729
Practice Address - Street 1:3307 SIR HENRY ST
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-5831
Practice Address - Country:US
Practice Address - Phone:832-646-3349
Practice Address - Fax:423-822-5729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0679422084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty