Provider Demographics
NPI:1972341287
Name:HIGH DESERT HEALING LLC
Entity type:Organization
Organization Name:HIGH DESERT HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SUBSTANCE USE COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CLEMENS
Authorized Official - Suffix:
Authorized Official - Credentials:CADC
Authorized Official - Phone:775-623-7770
Mailing Address - Street 1:405 W 4TH ST # 112
Mailing Address - Street 2:
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-3309
Mailing Address - Country:US
Mailing Address - Phone:775-623-7770
Mailing Address - Fax:
Practice Address - Street 1:530 MELARKEY ST STE 215
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3168
Practice Address - Country:US
Practice Address - Phone:775-623-7770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty