Provider Demographics
NPI:1710564240
Name:HEIWA CENTER - NORTH
Entity Type:Organization
Organization Name:HEIWA CENTER - NORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:330-859-2913
Mailing Address - Street 1:8949 STATE ROUTE 800 NE
Mailing Address - Street 2:
Mailing Address - City:MINERAL CITY
Mailing Address - State:OH
Mailing Address - Zip Code:44656-9214
Mailing Address - Country:US
Mailing Address - Phone:330-859-2913
Mailing Address - Fax:
Practice Address - Street 1:8949 STATE ROUTE 800 NE
Practice Address - Street 2:
Practice Address - City:MINERAL CITY
Practice Address - State:OH
Practice Address - Zip Code:44656-9214
Practice Address - Country:US
Practice Address - Phone:330-859-2913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty