Provider Demographics
NPI:1801425335
Name:HIGHER GROUND WELLNESS GROUP LTD
Entity type:Organization
Organization Name:HIGHER GROUND WELLNESS GROUP LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-317-2056
Mailing Address - Street 1:1053 LAKE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1144
Mailing Address - Country:US
Mailing Address - Phone:773-317-2056
Mailing Address - Fax:
Practice Address - Street 1:1053 LAKE ST STE 3
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1144
Practice Address - Country:US
Practice Address - Phone:773-317-2056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-06
Last Update Date:2024-12-17
Deactivation Date:2024-11-08
Deactivation Code:
Reactivation Date:2024-12-09
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty