Provider Demographics
NPI:1972975225
Name:HEALING LIFE HEALTH CENTER LLC
Entity type:Organization
Organization Name:HEALING LIFE HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:318-450-2300
Mailing Address - Street 1:PO BOX 1497
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71221-1497
Mailing Address - Country:US
Mailing Address - Phone:318-450-2300
Mailing Address - Fax:318-283-0210
Practice Address - Street 1:2410 FERRAND ST STE 9&10
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3242
Practice Address - Country:US
Practice Address - Phone:318-323-1560
Practice Address - Fax:318-323-5682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health