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MARYLAND WELLNESS LLC NPI 1588379739


NPI Information

NPI: 1588379739
Provider Name: MARYLAND WELLNESS LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
4128 HAYWARD AVE # W
BALTIMORE, MD
ZIP 21215
Phone: (410) 314-1030
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MARYLAND WELLNESS LLC is a mental health (including community mental health center) clinic center in Baltimore, MD. MARYLAND WELLNESS LLC NPI is 1588379739. The provider is registered as an organization entity type.

The provider's business location address is:

4128 HAYWARD AVE # W
BALTIMORE, MD
ZIP 21215-340
Phone: (410) 314-1030
Fax: (410) 314-1030

The provider's authorized official is Casey Wu .
The authorized official title is Director and has the following contact phone number (214) 659-1503.

The enumeration date for this NPI number is 1/20/2023 and was last updated on 3/15/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterNo
2261QR0400XClinic/CenterRehabilitationNo
3261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1220412462OTHERMARYLANDMD DEPARTMENT OF HEALTH - OMHC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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