Provider Demographics
NPI:1780861948
Name:HEALING HANDS WELLNESS CENTER INC
Entity type:Organization
Organization Name:HEALING HANDS WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:RETHA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:DOUGHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-582-4901
Mailing Address - Street 1:106 S MAPLE ST
Mailing Address - Street 2:PO BOX 460
Mailing Address - City:PLAINVIEW
Mailing Address - State:NE
Mailing Address - Zip Code:68769-4124
Mailing Address - Country:US
Mailing Address - Phone:402-582-4901
Mailing Address - Fax:402-582-3901
Practice Address - Street 1:106 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NE
Practice Address - Zip Code:68769-4124
Practice Address - Country:US
Practice Address - Phone:402-582-4901
Practice Address - Fax:402-582-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1483305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025575800Medicaid