Provider Demographics
NPI:1710282942
Name:HIGHER OCTAVE HEALING, INC.
Entity Type:Organization
Organization Name:HIGHER OCTAVE HEALING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KYMLA
Authorized Official - Middle Name:
Authorized Official - Last Name:EUBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:480-965-1082
Mailing Address - Street 1:PO BOX 7608
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-0021
Mailing Address - Country:US
Mailing Address - Phone:480-965-1082
Mailing Address - Fax:480-727-9697
Practice Address - Street 1:200 EAST CURRY ROAD (NO MAIL HERE)
Practice Address - Street 2:#307
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281
Practice Address - Country:US
Practice Address - Phone:480-965-1082
Practice Address - Fax:480-727-9697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ195678Medicaid
AZ331210Medicaid