Provider Demographics
NPI:1912773870
Name:TAMMY'S MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:TAMMY'S MENTAL HEALTH SERVICES LLC
Other - Org Name:INTEGRATIVE HEALING MENTAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/APRN
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WORD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:218-929-8011
Mailing Address - Street 1:2019 12TH AVE E
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-1741
Mailing Address - Country:US
Mailing Address - Phone:218-929-8011
Mailing Address - Fax:
Practice Address - Street 1:522 E HOWARD ST STE 85
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-1905
Practice Address - Country:US
Practice Address - Phone:218-929-8011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)