Provider Demographics
NPI:1750160867
Name:ZION HEALING CENTERS NC LLC
Entity type:Organization
Organization Name:ZION HEALING CENTERS NC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-653-9668
Mailing Address - Street 1:PO BOX 1356
Mailing Address - Street 2:
Mailing Address - City:RANDLEMAN
Mailing Address - State:NC
Mailing Address - Zip Code:27317-2356
Mailing Address - Country:US
Mailing Address - Phone:336-653-9668
Mailing Address - Fax:
Practice Address - Street 1:4045 PREMIER DR STE 101
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-9431
Practice Address - Country:US
Practice Address - Phone:336-653-9668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center