| NPI | 1427639822 |
|---|---|
| Former Legal Business Name | HEALING SPACE, LLC |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL KENNEDY Owner 337-222-5880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2021-05-20 |