Healthcare Provider Details

I. General information

NPI: 1356219109
Provider Name (Legal Business Name): HOLLAND WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 BLOOMINGDALE RD
BALTIMORE MD
21216-3002
US

IV. Provider business mailing address

1905 BLOOMINGDALE RD
BALTIMORE MD
21216-3002
US

V. Phone/Fax

Practice location:
  • Phone: 410-499-1334
  • Fax:
Mailing address:
  • Phone: 410-499-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. ANGELA NELSON
Title or Position: OWNER
Credential:
Phone: 410-499-1334