Mindhaven Healthcare Inc

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Legal business name

MINDHAVEN HEALTHCARE INC

Practice address

8130 Hickory Hollow Dr
Glen Burnie, MD 21060-8640

Phone

(361) 389-2387

NPI assigned

Aug 10, 2024

Last updated

Nov 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Felix Osegboun

Title

Managing Director

Phone

(361) 389-2387

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1723248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730505600000",
    "number": "1760213888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8130 HICKORY HOLLOW DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608640",
            "telephone_number": "361-389-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8130 HICKORY HOLLOW DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608640",
            "telephone_number": "361-389-2387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDHAVEN HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-10",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A",
        "authorized_official_last_name": "OSEGBOUN",
        "authorized_official_first_name": "FELIX",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "361-389-2387"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark L. Miller, P.T.
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• Child Intellectual and/or Developmental Disabilities Respite Care in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.