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General NPI Number Information
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NPI Number | 1174210496
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Entity Type | Organization
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Legal Business Name | EASY CHOICE WELLNESS CENTER LLC
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 940 MADISON AVE STE 201
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City | BALTIMORE
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State | MD
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Zip | 21201-2113
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Country | US
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Telephone | 410-826-0434
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Fax |
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Provider Business Mailing Address
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Address Line | 940 MADISON AVE STE 201
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City | BALTIMORE
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State | MD
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Zip | 21201-2113
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Country | US
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Telephone | 410-826-0434
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MRS. JESSICA JAMES
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Credential |
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Telephone | 410-622-7437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health 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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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