Provider Demographics
NPI:1932575891
Name:HEALING LIVES, LLC
Entity type:Organization
Organization Name:HEALING LIVES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOISJOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC
Authorized Official - Phone:651-315-5254
Mailing Address - Street 1:6600 FRANCE AVE S STE 418
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1805
Mailing Address - Country:US
Mailing Address - Phone:651-315-5254
Mailing Address - Fax:
Practice Address - Street 1:6600 FRANCE AVE S STE 418
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-1805
Practice Address - Country:US
Practice Address - Phone:651-315-5254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREGNANCY & POSTPARTUM SUPPORT MN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty