Provider Demographics
NPI:1548620958
Name:ADVANCED HEALING INC
Entity type:Organization
Organization Name:ADVANCED HEALING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-363-5839
Mailing Address - Street 1:91-1099 WAIEMI ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6413
Mailing Address - Country:US
Mailing Address - Phone:302-363-5839
Mailing Address - Fax:302-424-7755
Practice Address - Street 1:91-1099 WAIEMI ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-6413
Practice Address - Country:US
Practice Address - Phone:302-363-5839
Practice Address - Fax:302-424-7755
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRE-HOSPITAL INTERVENTIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-26
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WW0000X
HIAPRN-754363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty