The Healing Palace Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

THE HEALING PALACE INC

Practice address

2089 Anita Ave
Grosse Pointe Woods, MI 48236-1427

Phone

(313) 459-6707

Fax

(313) 731-0360

NPI assigned

Apr 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Chontay Detria Taylor Glenn, PHD, RN, PMHNP-BC

Title

Founder and Ceo

Phone

(313) 459-6707

Specialties & licenses 3

Addresses

Other names 1

• DIVINE INTERVENTIONS Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• The Healing Palace Inc

  • Addiction (Substance Use Disorder) Psychologist
  • Grosse Pointe Park, MI
  • NPI 1285038885
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chontay Glenn, PHD, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Grosse Pointe Woods, MI
  • NPI 1164631727
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1407020993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2089 ANITA AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361427",
            "telephone_number": "313-459-6707",
            "fax_number": "313-731-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 ANITA AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361427",
            "telephone_number": "313-459-6707",
            "fax_number": "313-731-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HEALING PALACE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "TAYLOR GLENN",
        "authorized_official_first_name": "CHONTAY",
        "authorized_official_middle_name": "DETRIA",
        "authorized_official_title_or_position": "FOUNDER AND CEO",
        "authorized_official_telephone_number": "313-459-6707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, RN, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "470408682",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MI",
            "license": "4704208682",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIVINE INTERVENTIONS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.