Provider Demographics
NPI:1427731652
Name:TRUE NORTH HEALING AND THERAPY LLC
Entity type:Organization
Organization Name:TRUE NORTH HEALING AND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:BROCK
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:832-609-9113
Mailing Address - Street 1:PO BOX 196
Mailing Address - Street 2:
Mailing Address - City:SAN CRISTOBAL
Mailing Address - State:NM
Mailing Address - Zip Code:87564-0195
Mailing Address - Country:US
Mailing Address - Phone:832-609-9113
Mailing Address - Fax:
Practice Address - Street 1:140 CAMINO DEL MEDIO
Practice Address - Street 2:
Practice Address - City:SAN CRISTOBAL
Practice Address - State:NM
Practice Address - Zip Code:87564
Practice Address - Country:US
Practice Address - Phone:832-609-9113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty