Provider Demographics
NPI:1306369251
Name:THE HEALING JOURENY
Entity type:Organization
Organization Name:THE HEALING JOURENY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-502-1927
Mailing Address - Street 1:791 S 4TH AVE STE E
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-3067
Mailing Address - Country:US
Mailing Address - Phone:928-920-6220
Mailing Address - Fax:
Practice Address - Street 1:791 S 4TH AVE STE E
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-3067
Practice Address - Country:US
Practice Address - Phone:928-920-6220
Practice Address - Fax:928-259-7272
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HEALING JOURNEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-24
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCSLG8358101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty