Provider Demographics
NPI:1790086650
Name:JOURNEYS OF HEALING, INC
Entity Type:Organization
Organization Name:JOURNEYS OF HEALING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGGOW
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:507-841-0060
Mailing Address - Street 1:204 2ND ST
Mailing Address - Street 2:PO BOX 136
Mailing Address - City:JACKSON
Mailing Address - State:MN
Mailing Address - Zip Code:56143-1638
Mailing Address - Country:US
Mailing Address - Phone:507-841-0060
Mailing Address - Fax:507-847-4750
Practice Address - Street 1:204 2ND ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MN
Practice Address - Zip Code:56143-1638
Practice Address - Country:US
Practice Address - Phone:507-841-0060
Practice Address - Fax:507-847-4750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5335251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health