Provider Demographics
NPI:1245655042
Name:HEALING RIVERS, PLLC
Entity type:Organization
Organization Name:HEALING RIVERS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/BUSINESS OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:PHYLLIS
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:952-412-6997
Mailing Address - Street 1:14824 RIVER XING
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2966
Mailing Address - Country:US
Mailing Address - Phone:952-412-6997
Mailing Address - Fax:
Practice Address - Street 1:3285 144TH ST W
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-4020
Practice Address - Country:US
Practice Address - Phone:952-412-6997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health