Organization
HEALING HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVANA MITIC CRNA, PMHNP (CEO)
(713) 412-3462
Entity
Organization
Contact information
Practice address
909 RIDGEBROOK RD STE 202B, SPARKS, MD 21152-9476
(410) 870-5482
Mailing address
909 RIDGEBROOK RD STE 202B, SPARKS, MD 21152-9476
(410) 870-5482
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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