Provider Demographics
NPI:1508322363
Name:HEAL FROM ADDICTION, LLC
Entity Type:Organization
Organization Name:HEAL FROM ADDICTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMIL
Authorized Official - Middle Name:P
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-981-2792
Mailing Address - Street 1:7 S HOWARD ST STE 210
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-3816
Mailing Address - Country:US
Mailing Address - Phone:509-688-0147
Mailing Address - Fax:509-688-0148
Practice Address - Street 1:7 S HOWARD ST STE 210
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3816
Practice Address - Country:US
Practice Address - Phone:509-688-0147
Practice Address - Fax:509-688-0148
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEAL FROM ADDICTION, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty