Provider Demographics
NPI:1235673039
Name:HEALING RESOURCES, LLC.
Entity Type:Organization
Organization Name:HEALING RESOURCES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:BLAINE
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CAP, NCGC-II
Authorized Official - Phone:305-310-6618
Mailing Address - Street 1:2100 LAKE IDA RD STE 2
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-2442
Mailing Address - Country:US
Mailing Address - Phone:305-310-6618
Mailing Address - Fax:
Practice Address - Street 1:2100 LAKE IDA RD STE 2
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2442
Practice Address - Country:US
Practice Address - Phone:305-310-6618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW12706261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation