NPIMap

Organization Active NPI

Healing House, LLC

  • Health Service Clinic/Center
  • Sparks, MD
National Provider Identifier
1366262990
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
HEALING HOUSE, LLC
Practice address
909 Ridgebrook Rd Ste 202B
Sparks, MD 21152-9476
Phone
(410) 870-5482
NPI assigned
Oct 17, 2024
Last updated
Oct 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Ivana Mitic, CRNA, PMHNPNPI 1962743815
Title
Ceo
Phone
(713) 412-3462

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

909 Ridgebrook Rd Ste 202B
Sparks, MD 21152-9476

Mailing address

909 Ridgebrook Rd Ste 202B
Sparks, MD 21152-9476
Phone (410) 870-5482

National Provider Directory

National Provider Directory

Locations

909 Ridgebrook Rd
Ste 202B
Sparks, MD 21152
Phone (410) 870-5482

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1366262990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 RIDGEBROOK RD STE 202B",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529476",
            "telephone_number": "410-870-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 RIDGEBROOK RD STE 202B",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529476",
            "telephone_number": "410-870-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "MITIC",
        "authorized_official_first_name": "IVANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-412-3462",
        "authorized_official_credential": "CRNA, PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.