Provider Demographics
NPI:1801387741
Name:HEALING STONES FOUNDATION INC.
Entity Type:Organization
Organization Name:HEALING STONES FOUNDATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:HILLARY
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:760-998-2988
Mailing Address - Street 1:13312 RANCHERO RD STE 18
Mailing Address - Street 2:
Mailing Address - City:OAK HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92344-4802
Mailing Address - Country:US
Mailing Address - Phone:760-998-2988
Mailing Address - Fax:760-998-2902
Practice Address - Street 1:13708 WOODPECKER RD
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92394-7615
Practice Address - Country:US
Practice Address - Phone:760-998-2988
Practice Address - Fax:760-998-2902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-26
Last Update Date:2018-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X, 322D00000X, 385H00000X, 385HR2050X
CA322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No385H00000XRespite Care FacilityRespite Care