Provider Demographics
NPI:1932709177
Name:HEAL BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:HEAL BEHAVIORAL HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BERCASIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-213-9356
Mailing Address - Street 1:4660 EL CAJON BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-4464
Mailing Address - Country:US
Mailing Address - Phone:619-213-9356
Mailing Address - Fax:
Practice Address - Street 1:4660 EL CAJON BLVD STE 105
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-4464
Practice Address - Country:US
Practice Address - Phone:619-213-9356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty