Provider Demographics
NPI:1891477030
Name:MANAGING LOVING HEALING MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:MANAGING LOVING HEALING MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STASHA
Authorized Official - Middle Name:YOSHEKIA
Authorized Official - Last Name:MAIDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-305-9912
Mailing Address - Street 1:4410 CLAIBORNE SQ E STE 334
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2074
Mailing Address - Country:US
Mailing Address - Phone:470-305-9912
Mailing Address - Fax:757-765-6570
Practice Address - Street 1:4410 CLAIBORNE SQ E STE 334
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2074
Practice Address - Country:US
Practice Address - Phone:470-305-9912
Practice Address - Fax:757-765-6570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health