Provider Demographics
NPI:1992136915
Name:HEALING ENTERPRISES
Entity type:Organization
Organization Name:HEALING ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASDOURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-755-6757
Mailing Address - Street 1:1443 E WASHINGTON BLVD
Mailing Address - Street 2:664
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-2650
Mailing Address - Country:US
Mailing Address - Phone:626-765-7111
Mailing Address - Fax:
Practice Address - Street 1:1443 E WASHINGTON BLVD
Practice Address - Street 2:664
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-2650
Practice Address - Country:US
Practice Address - Phone:626-765-7111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-01
Last Update Date:2013-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACEP 15950320800000X
CA45185912323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility