Provider Demographics
NPI:1477970721
Name:HEALING VISTAS, LLC
Entity Type:Organization
Organization Name:HEALING VISTAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CMHC
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:WADLEIGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-865-6122
Mailing Address - Street 1:7804 W STEP MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-3642
Mailing Address - Country:US
Mailing Address - Phone:801-865-6122
Mailing Address - Fax:
Practice Address - Street 1:151 E 5600 S STE 302
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-8149
Practice Address - Country:US
Practice Address - Phone:801-865-6122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty