Provider Demographics
NPI:1326751470
Name:HEALING TOGETHER LLC
Entity Type:Organization
Organization Name:HEALING TOGETHER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLA
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:208-805-5346
Mailing Address - Street 1:1619 N LINDER RD STE 104
Mailing Address - Street 2:
Mailing Address - City:KUNA
Mailing Address - State:ID
Mailing Address - Zip Code:83634-3010
Mailing Address - Country:US
Mailing Address - Phone:208-805-5346
Mailing Address - Fax:
Practice Address - Street 1:1619 N LINDER RD STE 104
Practice Address - Street 2:
Practice Address - City:KUNA
Practice Address - State:ID
Practice Address - Zip Code:83634-3010
Practice Address - Country:US
Practice Address - Phone:208-805-5346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)