Healthcare Provider Details

I. General information

NPI: 1043145444
Provider Name (Legal Business Name): PNAG, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CENTRAL AVE STE 202
GLEN BURNIE MD
21061-3470
US

IV. Provider business mailing address

7 CENTRAL AVE STE 203
GLEN BURNIE MD
21061-3470
US

V. Phone/Fax

Practice location:
  • Phone: 410-344-2852
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIEL NGANGA
Title or Position: OWNER
Credential:
Phone: 703-470-3514