Provider Demographics
NPI:1598235426
Name:THE HEALING PLACE, LLC
Entity Type:Organization
Organization Name:THE HEALING PLACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGRAND
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:803-665-2602
Mailing Address - Street 1:3907 WRIGHTSVILLE AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6251
Mailing Address - Country:US
Mailing Address - Phone:803-665-2602
Mailing Address - Fax:910-799-6171
Practice Address - Street 1:3907 WRIGHTSVILLE AVE STE 110
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-799-6162
Practice Address - Fax:910-799-6171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty