NPIMap

Organization Active NPI

Healing Minds Wellness Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1831840909
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
HEALING MINDS WELLNESS CENTER, LLC
Practice address
3600 Pulaski Hwy
Baltimore, MD 21224-1534
Phone
(443) 869-3137
NPI assigned
Jan 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Authorized official

Name
Ms. Kenyona Davis, LMSW
Title
Ceo
Phone
(202) 729-0018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

3600 Pulaski Hwy
Baltimore, MD 21224-1534

Mailing address

1706 Maco Dr
Hanover, MD 21076-1399
Phone (202) 729-0018

Other identifiers 1

IdentifierTypeStateIssuer
444622400MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Healing Minds Wellness Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1831840909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 MACO DR",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761399",
            "telephone_number": "202-729-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 PULASKI HWY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212241534",
            "telephone_number": "443-869-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING MINDS WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KENYONA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-729-0018",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444622400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.