Provider Demographics
NPI:1295775658
Name:HEALTHY LIVING INSTITUTE
Entity type:Organization
Organization Name:HEALTHY LIVING INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN PSYCH/MH
Authorized Official - Phone:660-584-5560
Mailing Address - Street 1:14 E 18TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HIGGINSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64037-1358
Mailing Address - Country:US
Mailing Address - Phone:660-584-5560
Mailing Address - Fax:660-584-5562
Practice Address - Street 1:14 E 18TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HIGGINSVILLE
Practice Address - State:MO
Practice Address - Zip Code:64037-1358
Practice Address - Country:US
Practice Address - Phone:660-584-5560
Practice Address - Fax:660-584-5562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN043218163WP0807X, 163WP0809X
MO00404103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Single Specialty
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOT060000Medicare ID - Type UnspecifiedGROUP