Provider Demographics
NPI:1841650439
Name:HEALING & RESTORATION CONSULTING LLC
Entity type:Organization
Organization Name:HEALING & RESTORATION CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:N
Authorized Official - Last Name:GIVENS-HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-916-0945
Mailing Address - Street 1:18397 CHENNAULT WAY
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-1124
Mailing Address - Country:US
Mailing Address - Phone:612-916-0945
Mailing Address - Fax:952-388-2526
Practice Address - Street 1:6385 OLD SHADY OAK RD STE 250
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7705
Practice Address - Country:US
Practice Address - Phone:612-216-1114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)