Provider Demographics
NPI:1669821419
Name:HEALING PLACE PASTORAL CARE CENTER
Entity Type:Organization
Organization Name:HEALING PLACE PASTORAL CARE CENTER
Other - Org Name:THE HEALING PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV
Authorized Official - Phone:318-308-2334
Mailing Address - Street 1:1429 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8250
Mailing Address - Country:US
Mailing Address - Phone:318-308-2334
Mailing Address - Fax:318-449-3683
Practice Address - Street 1:1429 3RD ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8250
Practice Address - Country:US
Practice Address - Phone:318-308-2334
Practice Address - Fax:318-449-3683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-11
Last Update Date:2016-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty