Healthcare Provider Details

I. General information

NPI: 1972469971
Provider Name (Legal Business Name): A JOURNEY TO WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 BARNSBURY ST
MIDDLE RIVER MD
21220-3164
US

IV. Provider business mailing address

510 BARNSBURY ST
MIDDLE RIVER MD
21220-3164
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 TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

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