Provider Demographics
NPI:1083419287
Name:SACRED SOL HEALING INSTITUTE
Entity type:Organization
Organization Name:SACRED SOL HEALING INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:CRM, PSS, CADC, QMHA
Authorized Official - Phone:541-281-9330
Mailing Address - Street 1:PO BOX 1694
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-0095
Mailing Address - Country:US
Mailing Address - Phone:541-281-9330
Mailing Address - Fax:541-205-6000
Practice Address - Street 1:501 MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-6056
Practice Address - Country:US
Practice Address - Phone:541-281-9330
Practice Address - Fax:541-205-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No302R00000XManaged Care OrganizationsHealth Maintenance Organization