Provider Demographics
NPI:1649939711
Name:HEALING HANDS INTEGRATED PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:HEALING HANDS INTEGRATED PSYCHIATRIC SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHIAZOR
Authorized Official - Middle Name:
Authorized Official - Last Name:EZIAKOR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:404-849-7485
Mailing Address - Street 1:3017 BELLINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-2191
Mailing Address - Country:US
Mailing Address - Phone:404-849-7485
Mailing Address - Fax:
Practice Address - Street 1:1 GLENLAKE PKWY
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3448
Practice Address - Country:US
Practice Address - Phone:404-849-7485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty