Healthcare Provider Details

I. General information

NPI: 1134031156
Provider Name (Legal Business Name): FREEDOM WELLNESS SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 WENTWORTH RD
GWYNN OAK MD
21207-7476
US

IV. Provider business mailing address

1107 DUNDALK AVE
BALTIMORE MD
21224-3020
US

V. Phone/Fax

Practice location:
  • Phone: 443-527-9900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL DACRE
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 410-512-6167