Provider Demographics
NPI:1639947229
Name:TRUE TO YOUR HEART HEALING LLC
Entity Type:Organization
Organization Name:TRUE TO YOUR HEART HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KETTENRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-432-0564
Mailing Address - Street 1:5784 S 900 E STE 3
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-1689
Mailing Address - Country:US
Mailing Address - Phone:801-432-0564
Mailing Address - Fax:
Practice Address - Street 1:5784 S 900 E STE 3
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84121-1689
Practice Address - Country:US
Practice Address - Phone:801-432-0564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty