Healthcare Provider Details

I. General information

NPI: 1598349789
Provider Name (Legal Business Name): CONFIDENT BODIES & WHOLENESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5248 REISTERSTOWN RD APT 2
BALTIMORE MD
21215-5083
US

IV. Provider business mailing address

2127 LORRAINE AVE
GWYNN OAK MD
21207-5909
US

V. Phone/Fax

Practice location:
  • Phone: 672-052-0856
  • Fax:
Mailing address:
  • Phone: 410-419-4754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: AFRIKUS HART
Title or Position: OWNER
Credential:
Phone: 410-419-4754