Provider Demographics
NPI:1568109742
Name:THE HEALING CENTER INC
Entity type:Organization
Organization Name:THE HEALING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JON
Authorized Official - Last Name:MENDENHALL
Authorized Official - Suffix:
Authorized Official - Credentials:AS
Authorized Official - Phone:208-557-9450
Mailing Address - Street 1:444 HOSPITAL WAY STE 422
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-2744
Mailing Address - Country:US
Mailing Address - Phone:208-557-9450
Mailing Address - Fax:208-561-7111
Practice Address - Street 1:444 HOSPITAL WAY STE 422
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-2744
Practice Address - Country:US
Practice Address - Phone:208-557-9450
Practice Address - Fax:208-561-7111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)