Healthcare Provider Details

I. General information

NPI: 1053005561
Provider Name (Legal Business Name): WARREN W WRIGHT ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 NIMITZ RD
KENSINGTON MD
20895-1715
US

IV. Provider business mailing address

3525 NIMITZ RD
KENSINGTON MD
20895-1715
US

V. Phone/Fax

Practice location:
  • Phone: 240-221-1950
  • Fax:
Mailing address:
  • Phone: 240-221-1950
  • 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

VIII. Authorized Official

Name: RYAN WRIGHT
Title or Position: CHIEF OPERATIONS OFFICER
Credential: LSCW-C
Phone: 240-221-1950