Provider Demographics
NPI:1225550239
Name:CENTER FOR COMMUNITY HEALING LLC
Entity Type:Organization
Organization Name:CENTER FOR COMMUNITY HEALING LLC
Other - Org Name:THE CENTER FOR COMMUNITY HEALING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ART THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:OWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:608-282-5818
Mailing Address - Street 1:6314 ODANA RD STE E
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1194
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6314 ODANA RD STE E
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1194
Practice Address - Country:US
Practice Address - Phone:608-282-5818
Practice Address - Fax:608-282-5818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6407101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty