National Provider Identifier Database

HEAL THYSELF LLC
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

HEAL THYSELF LLC
3698 INNER PERIMETER RD STE 3603
VALDOSTA, GA31602-1047
Phone: 229-539-3710
Fax:
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for HEAL THYSELF LLC

NPI Number 1770178162
Legal business name
LBN
HEAL THYSELF LLC
Authorized official SHERRELL ECHOLS - (MS.)
Entity Organization
Organization subpart No
Enumeration date 03/08/2021
Last updated 03/08/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • GA Medicaid: 11-790-2611

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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