Provider Demographics
NPI:1922329747
Name:ORA HEALING CENTER
Entity Type:Organization
Organization Name:ORA HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LANA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-746-3507
Mailing Address - Street 1:5140 W MELROSE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-4224
Mailing Address - Country:US
Mailing Address - Phone:773-746-3507
Mailing Address - Fax:
Practice Address - Street 1:5140 W MELROSE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-4224
Practice Address - Country:US
Practice Address - Phone:773-746-3507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty