Provider Demographics
NPI:1114626686
Name:EMOTIONAL HEALING AND RECOVERY, LLC
Entity Type:Organization
Organization Name:EMOTIONAL HEALING AND RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JIMIKO
Authorized Official - Middle Name:W
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-288-3012
Mailing Address - Street 1:1009 ELLIS POND DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7881
Mailing Address - Country:US
Mailing Address - Phone:803-288-3012
Mailing Address - Fax:
Practice Address - Street 1:1166 CAMP CREEK RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-8558
Practice Address - Country:US
Practice Address - Phone:803-288-3012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty