Healthcare Provider Details

I. General information

NPI: 1538997127
Provider Name (Legal Business Name): MARYLAND WELLNESS AND RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4208 GARRETT PARK RD
SILVER SPRING MD
20906-4830
US

IV. Provider business mailing address

4208 GARRETT PARK RD
SILVER SPRING MD
20906-4830
US

V. Phone/Fax

Practice location:
  • Phone: 240-242-4225
  • Fax: 240-559-1571
Mailing address:
  • Phone: 240-242-4225
  • Fax: 240-559-1571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SAHAR GERAMIFAR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 240-242-4225