Provider Demographics
NPI:1417476607
Name:FOR THE HEALING OF THE NATIONS LLC
Entity Type:Organization
Organization Name:FOR THE HEALING OF THE NATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MATSKO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-717-0130
Mailing Address - Street 1:3635 OLD COURT RD STE 305
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3907
Mailing Address - Country:US
Mailing Address - Phone:443-717-0130
Mailing Address - Fax:410-630-1008
Practice Address - Street 1:3635 OLD COURT RD STE 305
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3907
Practice Address - Country:US
Practice Address - Phone:443-717-0130
Practice Address - Fax:443-327-4753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD105778200Medicaid
MDCX87-0001OtherCAREFIRST BLUE CROSS