Provider Demographics
NPI:1568827616
Name:WOUNDED HEALERS ENERGY CENTER, LLC
Entity Type:Organization
Organization Name:WOUNDED HEALERS ENERGY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:STRETTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-818-8273
Mailing Address - Street 1:11 E WASHINGTON ST STE C
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-1569
Mailing Address - Country:US
Mailing Address - Phone:740-818-8273
Mailing Address - Fax:
Practice Address - Street 1:187 E STATE ST STE C
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1764
Practice Address - Country:US
Practice Address - Phone:740-818-8273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty