Healthcare Provider Details
I. General information
NPI: 1386570620
Provider Name (Legal Business Name): ANEW BALANCE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5501 TWIN KNOLLS RD STE 107
COLUMBIA MD
21045-3260
US
IV. Provider business mailing address
306 W REDWOOD ST STE 201
BALTIMORE MD
21201-1708
US
V. Phone/Fax
- Phone: 240-981-9861
- Fax:
- Phone: 240-353-9181
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRYSTAL
WHITE
Title or Position: PMHNP-BC
Credential: RN, MSN, CRNP-PMH
Phone: 240-981-9861