Provider Demographics
NPI:1790195691
Name:HEALING ARTS CENTER
Entity type:Organization
Organization Name:HEALING ARTS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDAWRD
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:AP, LMHC
Authorized Official - Phone:239-262-6828
Mailing Address - Street 1:971 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-8803
Mailing Address - Country:US
Mailing Address - Phone:239-262-6828
Mailing Address - Fax:239-649-4915
Practice Address - Street 1:971 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-8803
Practice Address - Country:US
Practice Address - Phone:239-262-6828
Practice Address - Fax:239-649-4915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2616261QM0801X
FLAP488171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1083830863OtherNATIONAL PLAN & PROVIDER ENUMERATION SYSTEM