Wild Heart Society Pllc

LBN: Wild Heart Society Pllc
Wild Heart Society Pllc is an health care organization with primary practice located at 15604 Ne 28Th Ave , Vancouver WA 98686-1541. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Ambulatory Health Care Facilities / Adolescent and Children Mental Health is the primary health care specialty. Wild Heart Society Pllc can be contacted via phone (360) 521-3055, or through Dunham, Mackenzie via phone (360) 521-3055.

Contact Information

Primary practice address
15604 Ne 28Th Ave Vancouver WA 98686-1541
Phone: (360) 521-3055
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Dunham, Mackenzie Licensed Clinical Social Worker (LCSW)
Phone: (360) 521-3055

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X

Profile Details

NPI number 1700344298
LBN Legal business name Wild Heart Society Pllc
DBA Doing business as
Authorized official Dunham, Mackenzie Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 4th, 2019
Last updated Mar 4th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers