Provider Demographics
NPI:1275234122
Name:HEALING HANDS ADDICTION CENTERS LLC
Entity Type:Organization
Organization Name:HEALING HANDS ADDICTION CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-466-4400
Mailing Address - Street 1:917 MARY B ST STE 8
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71653-1625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:917 MARY B ST STE 8
Practice Address - Street 2:
Practice Address - City:LAKE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71653-1625
Practice Address - Country:US
Practice Address - Phone:870-466-4400
Practice Address - Fax:870-466-4556
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALING HANDS ADDICTION CENTERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility