Provider Demographics
NPI:1902635667
Name:INCLUSIVE HEALING CENTER LLC
Entity type:Organization
Organization Name:INCLUSIVE HEALING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUADAGNI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:689-282-8312
Mailing Address - Street 1:1515 E LIVINGSTON ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5435
Mailing Address - Country:US
Mailing Address - Phone:689-282-8312
Mailing Address - Fax:
Practice Address - Street 1:1515 E LIVINGSTON ST UNIT B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5435
Practice Address - Country:US
Practice Address - Phone:689-282-8312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty