Healthcare Provider Details

I. General information

NPI: 1255214177
Provider Name (Legal Business Name): A BETTER LIVING WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 YORK RD STE 800 LT9
LUTHERVILLE MD
21093-6011
US

IV. Provider business mailing address

1301 YORK RD STE 800 LT9
LUTHERVILLE MD
21093-6011
US

V. Phone/Fax

Practice location:
  • Phone: 410-816-4401
  • Fax:
Mailing address:
  • Phone: 410-816-4401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: SIARA BAZEMORE
Title or Position: OWNER
Credential:
Phone: 410-816-4401