# HEALING WATERS OF WNY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Healing Waters
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659884047
- **Authorized official:** TRAVIS HART (OWNER)
- **Authorized official phone:** (716) 308-1974

## Contact information

- **Practice address:** 542 QUAKER RD, EAST AURORA, NY 14052-2118
- **Practice address phone:** (716) 655-3924
- **Mailing address:** 542 QUAKER RD, EAST AURORA, NY 14052-2118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/08/2017
- **Last updated:** 11/08/2017