Mission House Inc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

MISSION HOUSE INC

Practice address

204 Brown St
Chestertown, MD 21620-1402

Phone

(516) 314-8460

NPI assigned

Dec 16, 2019

Organization subpart

No

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

Authorized official

Name

Chrissy Chisolm

Title

Director

Phone

(516) 314-8460

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1821636226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 N BROOK DR",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216172762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 BROWN ST",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201402",
            "telephone_number": "516-314-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "CHISOLM",
        "authorized_official_first_name": "CHRISSY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "516-314-8460"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Lynne McDougle, CRNA
• Barbara J. McLendon, AU.D.
• Courtney Marie Miller, LCSW-C
• Melinda F Miller, MSN, CRNP
• Kanchan Arjan Mirchandani
• Deborah Mizeur, CNS
• Catherine Wingfield Molz, LCSWC
• Timothy James Monahan, D.P.M.
• Kayla Moore
• Thaddeus L Moore Jr.

• Mental Illness Community Based Residential Treatment Facility in Chestertown, MD
• Providers in Chestertown, MD by specialty
• Mental Illness Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.