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MISHA HOUSE LLC NPI 1164883344


NPI Information

NPI: 1164883344
Provider Name: MISHA HOUSE, LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 21D2124079

Address:
2300 GARRISON BLVD
SUITE 120
BALTIMORE, MD
ZIP 21216
Phone: (443) 708-3054
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MISHA HOUSE, LLC is a rehabilitation and substance use disorder clinic center in Baltimore, MD. MISHA HOUSE, LLC NPI is 1164883344. The provider is registered as an organization entity type.

The provider's business location address is:

2300 GARRISON BLVD
SUITE 120
BALTIMORE, MD
ZIP 21216
Phone: (443) 708-3054
Fax: (443) 708-4402

The provider's authorized official is Monica White .
The authorized official title is Executive Director and has the following contact phone number (443) 708-3054.

The CLIA number assigned to this NPI record is 21D2124079 - other - mental health recovery with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/15/2016 and was last updated on 10/19/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0405XClinic/CenterRehabilitation, Substance Use Disorder261QR0405XMARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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