Healthcare Provider Details

I. General information

NPI: 1497349997
Provider Name (Legal Business Name): BLUE SPRING WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 S FRONT ST
BALTIMORE MD
21202-4605
US

IV. Provider business mailing address

8 HALLSDALE CT
ROSEDALE MD
21237-5009
US

V. Phone/Fax

Practice location:
  • Phone: 410-456-5812
  • Fax:
Mailing address:
  • Phone: 410-456-5812
  • 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 State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HOTENESIA NJOROGE
Title or Position: MEDICAL DIRECTOR
Credential: CRNP-PMH
Phone: 410-456-5812