Provider Demographics
NPI:1841069648
Name:AUSET HEALING CHAMBER
Entity type:Organization
Organization Name:AUSET HEALING CHAMBER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:IMANI
Authorized Official - Middle Name:
Authorized Official - Last Name:LYTCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-287-7958
Mailing Address - Street 1:1002 GEMINI ST STE 105
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2746
Mailing Address - Country:US
Mailing Address - Phone:623-287-7958
Mailing Address - Fax:
Practice Address - Street 1:1002 GEMINI ST STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2746
Practice Address - Country:US
Practice Address - Phone:623-287-7958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty