Provider Demographics
NPI:1083582704
Name:HEAL EXPERIENTIAL LLC
Entity type:Organization
Organization Name:HEAL EXPERIENTIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PINDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-598-9728
Mailing Address - Street 1:404 S MAIN ST # 128
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-3023
Mailing Address - Country:US
Mailing Address - Phone:530-598-9728
Mailing Address - Fax:530-842-7917
Practice Address - Street 1:575 WHITE AVE
Practice Address - Street 2:
Practice Address - City:WEED
Practice Address - State:CA
Practice Address - Zip Code:96094-2431
Practice Address - Country:US
Practice Address - Phone:530-598-9728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-24
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health