Organization
HEALING BRIDGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE M WACASER LCSW (LLC OWNER/PROVDER)
(417) 297-1952
Entity
Organization
Contact information
Practice address
1358 E KINGSLEY ST STE E, SPRINGFIELD, MO 65804-7245
(417) 414-0333
Mailing address
717 E PLACER MILL RD, NIXA, MO 65714-7100
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/10/2018
Last updated
12/10/2018
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