Provider Demographics
NPI:1477077667
Name:HEALTHY BEGINNINGS PREVENTATIVE HEALTH LLC
Entity Type:Organization
Organization Name:HEALTHY BEGINNINGS PREVENTATIVE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER/SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:509-948-8662
Mailing Address - Street 1:2836 COPPERBUTTE ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-5021
Mailing Address - Country:US
Mailing Address - Phone:509-948-8662
Mailing Address - Fax:
Practice Address - Street 1:2836 COPPERBUTTE ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-5021
Practice Address - Country:US
Practice Address - Phone:509-948-8662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-28
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00006889261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental