Provider Demographics
NPI:1962937888
Name:HEALING ARTS INSTITUTE OF SOUTH FLORIDA INTERNATIONAL INC.
Entity type:Organization
Organization Name:HEALING ARTS INSTITUTE OF SOUTH FLORIDA INTERNATIONAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:TENNIE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-459-1473
Mailing Address - Street 1:4699 N STATE ROAD 7 STE B1
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5870
Mailing Address - Country:US
Mailing Address - Phone:954-459-1473
Mailing Address - Fax:954-982-2799
Practice Address - Street 1:4699 N STATE ROAD 7 STE B1
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5870
Practice Address - Country:US
Practice Address - Phone:954-459-1473
Practice Address - Fax:954-982-2799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLN15000007106251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health