Provider Demographics
NPI:1689703852
Name:HEALING PLAINS MENTAL HEALTH, INC.
Entity Type:Organization
Organization Name:HEALING PLAINS MENTAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:308-432-6977
Mailing Address - Street 1:913 KING ST
Mailing Address - Street 2:
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2629
Mailing Address - Country:US
Mailing Address - Phone:308-432-6799
Mailing Address - Fax:308-432-6799
Practice Address - Street 1:913 KING ST
Practice Address - Street 2:P.O. BIX 826
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-2629
Practice Address - Country:US
Practice Address - Phone:308-432-6799
Practice Address - Fax:308-432-6799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1137251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025382300Medicaid