Provider Demographics
NPI:1114607017
Name:HEAL CENTER FOR COUNSELING AND COMPLEMENTARY HEALTH, LLC
Entity Type:Organization
Organization Name:HEAL CENTER FOR COUNSELING AND COMPLEMENTARY HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ARMINDA
Authorized Official - Middle Name:BERNICE
Authorized Official - Last Name:PERCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:912-574-8702
Mailing Address - Street 1:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:MITCHELLS
Mailing Address - State:VA
Mailing Address - Zip Code:22729-0123
Mailing Address - Country:US
Mailing Address - Phone:540-717-4212
Mailing Address - Fax:
Practice Address - Street 1:23301 CEDAR MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:RAPIDAN
Practice Address - State:VA
Practice Address - Zip Code:22733-1845
Practice Address - Country:US
Practice Address - Phone:540-717-4212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health