Provider Demographics
NPI:1255638011
Name:HEALTHY HEALING ACUPUNCTURE AND HERBAL CENTER LLC
Entity type:Organization
Organization Name:HEALTHY HEALING ACUPUNCTURE AND HERBAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAID
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:321-252-3720
Mailing Address - Street 1:1395 N COURTENAY PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-4475
Mailing Address - Country:US
Mailing Address - Phone:321-252-3720
Mailing Address - Fax:321-252-3752
Practice Address - Street 1:1395 N COURTENAY PKWY STE 202
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4475
Practice Address - Country:US
Practice Address - Phone:321-252-3720
Practice Address - Fax:321-252-3752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2871171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1902115116OtherINDIVIDUAL NPI