Provider Demographics
NPI:1457623902
Name:BEHAVIORAL HEALING, LLC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:M
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, PIP
Authorized Official - Phone:256-328-3988
Mailing Address - Street 1:PO BOX 8068
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35902-8068
Mailing Address - Country:US
Mailing Address - Phone:256-328-3988
Mailing Address - Fax:
Practice Address - Street 1:2721 ROBERTSON ST E
Practice Address - Street 2:
Practice Address - City:SOUTHSIDE
Practice Address - State:AL
Practice Address - Zip Code:35907-7723
Practice Address - Country:US
Practice Address - Phone:256-328-3988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health