Provider Demographics
NPI:1831667658
Name:JOURNEYS OF HEALING, LLC
Entity Type:Organization
Organization Name:JOURNEYS OF HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-407-2780
Mailing Address - Street 1:1029 3RD AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56187-2399
Mailing Address - Country:US
Mailing Address - Phone:507-822-4327
Mailing Address - Fax:
Practice Address - Street 1:1029 3RD AVE STE 2
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-2399
Practice Address - Country:US
Practice Address - Phone:507-407-2780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health