Healthcare Provider Details

I. General information

NPI: 1629906813
Provider Name (Legal Business Name): HOPE WELLNESS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 E PULASKI HWY
ELKTON MD
21921-6747
US

IV. Provider business mailing address

349 E PULASKI HWY
ELKTON MD
21921-6747
US

V. Phone/Fax

Practice location:
  • Phone: 253-886-7324
  • Fax:
Mailing address:
  • Phone: 253-886-7324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ESPERANZA BALLENILLA
Title or Position: OWNER/PROGRAM DIRECTOR
Credential: LCSW-C
Phone: 253-886-7324