Provider Demographics
NPI:1063046217
Name:INSTITUTE FOR HEALING LLC
Entity Type:Organization
Organization Name:INSTITUTE FOR HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LA KEITA
Authorized Official - Middle Name:DENEEN
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:410-864-0211
Mailing Address - Street 1:9419 COMMON BROOK RD STE 208
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-7570
Mailing Address - Country:US
Mailing Address - Phone:410-530-3298
Mailing Address - Fax:
Practice Address - Street 1:9419 COMMON BROOK RD STE 208
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-7570
Practice Address - Country:US
Practice Address - Phone:410-530-3298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD9419Medicaid