Provider Demographics
NPI:1548387772
Name:HEALING HEALTH CENTER OF HAMMOND L.L.C.
Entity Type:Organization
Organization Name:HEALING HEALTH CENTER OF HAMMOND L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:LEIF
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:LENSGRAF
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:985-365-0001
Mailing Address - Street 1:1004 E THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-2737
Mailing Address - Country:US
Mailing Address - Phone:985-365-0001
Mailing Address - Fax:985-345-5528
Practice Address - Street 1:1004 E THOMAS ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-2737
Practice Address - Country:US
Practice Address - Phone:985-365-0001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CT96Medicare ID - Type Unspecified