1679699706 NPI number — HARMONY THERAPY AND WELLNESS LLC

Table of content: (NPI 1679699706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679699706 NPI number — HARMONY THERAPY AND WELLNESS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARMONY THERAPY AND WELLNESS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ELIZABETH HARMENING, OT, LLC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679699706
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
639 YORK
Provider Second Line Business Mailing Address:
ROOM 201
Provider Business Mailing Address City Name:
QUINCY
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
217-592-3665
Provider Business Mailing Address Fax Number:
419-791-5526

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
639 YORK
Provider Second Line Business Practice Location Address:
ROOM 201
Provider Business Practice Location Address City Name:
QUINCY
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-592-3665
Provider Business Practice Location Address Fax Number:
419-791-5526
Provider Enumeration Date:
03/21/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARMENING
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PRACTITIONER
Authorized Official Telephone Number:
217-592-3665

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  056-003111 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)