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General NPI Number Information
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NPI Number | 1033091426
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Entity Type | Organization
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Legal Business Name | FAIRFIELD HEALTH & WELLNESS LLC
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1001 PINE HEIGHTS AVE STE 201
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City | BALTIMORE
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State | MD
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Zip | 21229-5284
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Country | US
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Telephone | 281-844-6487
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 PINE HEIGHTS AVE STE 201
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City | BALTIMORE
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State | MD
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Zip | 21229-5284
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Country | US
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Telephone | 281-844-6487
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Fax |
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Authorized Official
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Title or Position | CEO AND PROGRAM DIRECTOR
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Name | MR. EMMANUEL CHIJIOKE ILOANYA
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Credential |
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Telephone | 281-844-6487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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