Provider Demographics
NPI:1114789906
Name:CENTER FOR GREATER HEALING LLC
Entity type:Organization
Organization Name:CENTER FOR GREATER HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDIS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:567-694-4679
Mailing Address - Street 1:3232 CENTRAL PARK DR W STE C
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-3011
Mailing Address - Country:US
Mailing Address - Phone:419-740-0402
Mailing Address - Fax:567-232-9178
Practice Address - Street 1:3232 CENTRAL PARK DR W STE C
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-3011
Practice Address - Country:US
Practice Address - Phone:419-740-0402
Practice Address - Fax:567-232-9178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty