Provider Demographics
NPI:1164607784
Name:THE HEALING TREE
Entity Type:Organization
Organization Name:THE HEALING TREE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-317-7430
Mailing Address - Street 1:601 W MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-6203
Mailing Address - Country:US
Mailing Address - Phone:407-317-7430
Mailing Address - Fax:407-540-1924
Practice Address - Street 1:601 W MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-6203
Practice Address - Country:US
Practice Address - Phone:407-317-7430
Practice Address - Fax:407-540-1924
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORLANDO REGINAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 5299302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization