Healthcare Provider Details
I. General information
NPI: 1346181278
Provider Name (Legal Business Name): WELBON INTEGRATED SUPPORTIVE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
233 E REDWOOD ST STE 500A
BALTIMORE MD
21202-6292
US
IV. Provider business mailing address
233 E REDWOOD ST STE 500A
BALTIMORE MD
21202-6292
US
V. Phone/Fax
- Phone: 240-217-7212
- Fax:
- Phone: 240-217-7212
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BENITA
WELBON
Title or Position: CEO
Credential: WELBON
Phone: 240-217-7212