Healthcare Provider Details

I. General information

NPI: 1780452318
Provider Name (Legal Business Name): HYGEA HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 MIDDLE RIVER ROAD
MIDDLE RIVER MD
21220
US

IV. Provider business mailing address

400 REDLAND CT STE 102
OWINGS MILLS MD
21117-3291
US

V. Phone/Fax

Practice location:
  • Phone: 410-559-1800
  • Fax:
Mailing address:
  • Phone: 410-707-6367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JORDANA BLESA
Title or Position: PRESIDENT
Credential:
Phone: 626-375-3309