Provider Demographics
NPI:1801418074
Name:SANA HEALING COLLECTIVE
Entity Type:Organization
Organization Name:SANA HEALING COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VILMARIE
Authorized Official - Middle Name:FRAGUADA
Authorized Official - Last Name:NARLOCH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:651-338-8231
Mailing Address - Street 1:2663 W. LELAND AVE.
Mailing Address - Street 2:#1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625
Mailing Address - Country:US
Mailing Address - Phone:651-338-8231
Mailing Address - Fax:
Practice Address - Street 1:405 N. WABASH STREET
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:651-338-8231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health