Organization · NPI-2

A Jewel Of Wellness, LLC

Clinic/Center, Mental Health (Including Community Mental Health Center) · Baltimore, MD

NPI number1215433784
StatusActive
Last updated in NPPESApr 3, 2018

Details

NPI
1215433784
Entity type
Organization (NPI-2)
Legal business name
A Jewel Of Wellness, LLC
Organization subpart
No
Enumeration date
Apr 3, 2018
Last updated
Apr 3, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

4915 Gilray Dr
Baltimore, MD 21214-2136

Phone 443-353-0306

Mailing address

4915 Gilray Dr
Baltimore, MD 21214-2136

Phone 443-353-0306

Authorized official

Latasha Wilson
Director
4433530306

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