Healthcare Provider Details

I. General information

NPI: 1831803535
Provider Name (Legal Business Name): A BETTER YOU HEALTH & WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 EASTERN BLVD STE A
MIDDLE RIVER MD
21220-4296
US

IV. Provider business mailing address

2201 EASTERN BLVD STE A
MIDDLE RIVER MD
21220-4296
US

V. Phone/Fax

Practice location:
  • Phone: 443-442-4242
  • Fax:
Mailing address:
  • Phone: 443-442-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. AISHA SHANE JACKSON
Title or Position: CEO AND PROGRAM DIRECTOR
Credential:
Phone: 443-442-4242