Provider Demographics
NPI:1164201232
Name:HEALING CLINIC LLC
Entity Type:Organization
Organization Name:HEALING CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NARGES
Authorized Official - Middle Name:
Authorized Official - Last Name:NIAROJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-474-2479
Mailing Address - Street 1:429 WINTER WALK DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-7808
Mailing Address - Country:US
Mailing Address - Phone:734-474-2479
Mailing Address - Fax:
Practice Address - Street 1:429 WINTER WALK DR
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-7808
Practice Address - Country:US
Practice Address - Phone:734-474-2479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty