Provider Demographics
NPI:1518615152
Name:HEALING WELL INTEGRATIVE COMMUNITY HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:HEALING WELL INTEGRATIVE COMMUNITY HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLETTE
Authorized Official - Middle Name:DENIENE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:859-492-9864
Mailing Address - Street 1:296 MEADOW VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-8788
Mailing Address - Country:US
Mailing Address - Phone:859-492-9864
Mailing Address - Fax:
Practice Address - Street 1:1426 N FORBES RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-8995
Practice Address - Country:US
Practice Address - Phone:859-492-9864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty