Provider Demographics
NPI: | 1083473789 |
---|---|
Name: | HEALING HOPE HEALTHCARE LLC |
Entity Type: | Organization |
Organization Name: | HEALING HOPE HEALTHCARE LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CO-OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | EBUNOLUWA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | AKINYEMI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DNP |
Authorized Official - Phone: | 443-653-9220 |
Mailing Address - Street 1: | 4132 E JOPPA RD STE 110-1251 |
Mailing Address - Street 2: | |
Mailing Address - City: | BALTIMORE |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 21236-2272 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4132 E JOPPA RD STE 110-1251 |
Practice Address - Street 2: | |
Practice Address - City: | BALTIMORE |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21236-2272 |
Practice Address - Country: | US |
Practice Address - Phone: | 443-304-8390 |
Practice Address - Fax: | 954-405-8786 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-03-15 |
Last Update Date: | 2024-04-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Single Specialty |