Provider Demographics
NPI:1740357714
Name:HEALING WHEEL, INC.
Entity type:Organization
Organization Name:HEALING WHEEL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RHODIAN
Authorized Official - Middle Name:JAMORA
Authorized Official - Last Name:RACAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-586-9788
Mailing Address - Street 1:30555 SOUTHFIELD RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-7751
Mailing Address - Country:US
Mailing Address - Phone:248-203-9998
Mailing Address - Fax:248-786-6788
Practice Address - Street 1:30555 SOUTHFIELD RD
Practice Address - Street 2:SUITE 208
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-7751
Practice Address - Country:US
Practice Address - Phone:248-203-9998
Practice Address - Fax:248-786-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237699Medicare Oscar/Certification