Provider Demographics
NPI:1891379038
Name:BARRON & BENDALL HEALING CENTER, LLC
Entity Type:Organization
Organization Name:BARRON & BENDALL HEALING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:FAYETTA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:937-241-9230
Mailing Address - Street 1:113 JAMES DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-5219
Mailing Address - Country:US
Mailing Address - Phone:937-241-9230
Mailing Address - Fax:
Practice Address - Street 1:340 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ENON
Practice Address - State:OH
Practice Address - Zip Code:45323-1058
Practice Address - Country:US
Practice Address - Phone:937-797-1926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty