Misha House, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

261QR0405X Issued in MD

Legal business name

MISHA HOUSE, LLC

Practice address

2300 Garrison Blvd
Suite 120
Baltimore, MD 21216

Phone

(443) 708-3054

Fax

(443) 708-4402

NPI assigned

Mar 15, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Monica White, MS, CAC-AD

Title

Executive Director

Phone

(443) 708-3054

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1164883344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD",
            "address_2": "SUITE 120",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21216",
            "telephone_number": "443-708-3054",
            "fax_number": "443-708-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD",
            "address_2": "SUITE 120",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21216",
            "telephone_number": "443-708-3054",
            "fax_number": "443-708-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISHA HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-15",
        "last_updated": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "443-708-3054",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, CAC-AD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "261QR0405X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sumeen Mirza
• Yusra Mirza, M.D.
• Lauren Mirzakhalili, LCSW-C
• Shapoor Mirzakwal
• Monika Misak, MD
• Omar Samer Mishael, M.D.
• Edward Barry Mishner, M.D.
• Mark Mishory
• Mishpacha Dental
• Mishpacha Refuah, LLC

• Substance Use Disorder Rehabilitation Clinic/Center in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.