Healing Haven Licensed Clinical
NPI #1144046608 in San Jacinto, California
Provider Information
- NPI Number
- 1144046608
- Entity Type
- Organization
- Organization Name
- Healing Haven Licensed Clinical
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Dec 2, 2024
- Last Updated
- Mar 20, 2025
Practice Location
- Address
- 315 E ESPLANADE AVE UNIT 89
- City
- San Jacinto
- State
- California
- ZIP Code
- 92583-5102
- Phone
- (951) 214-5071
Authorized Official
- Name
- KENYADA M WAGONER, LCSW
- Title
- OWNER/CEO
- Phone
- (951) 214-5071
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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