1104829019 NPI number — HEALING TOUCH HEALTHCARE

Table of content: (NPI 1104829019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104829019 NPI number — HEALING TOUCH HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING TOUCH HEALTHCARE
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:
Provider Other Organization Name Type Code:
6
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:
1104829019
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7031 CORPORATE WAY
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45459-4268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-610-5555
Provider Business Mailing Address Fax Number:
937-610-5554

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7031 CORPORATE WAY
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45459-4268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-610-5555
Provider Business Practice Location Address Fax Number:
937-610-5554
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ALI
Authorized Official First Name:
FAISAL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
937-610-5555

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  2547551 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 416661 . This is a "JOINT COMMISSION" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2547551 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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