Provider Demographics
NPI:1760007199
Name:HEALING HOOF STEPS CORPORATION
Entity Type:Organization
Organization Name:HEALING HOOF STEPS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-764-1005
Mailing Address - Street 1:3922 JACE DR
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-6510
Mailing Address - Country:US
Mailing Address - Phone:850-764-1005
Mailing Address - Fax:855-588-7389
Practice Address - Street 1:3922 JACE DR
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-6510
Practice Address - Country:US
Practice Address - Phone:850-764-1005
Practice Address - Fax:855-588-7389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty