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General NPI Number Information
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NPI Number | 1568351393
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Entity Type | Organization
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Legal Business Name | VINEYARD GENTLE CARE LLC
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 5870 BELAIR RD
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City | BALTIMORE
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State | MD
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Zip | 21206-2612
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Country | US
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Telephone | 410-559-4307
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Fax |
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Provider Business Mailing Address
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Address Line | 4132 E JOPPA RD STE 110-1169
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City | BALTIMORE
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State | MD
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Zip | 21236-2272
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PMHNP/ OWNER
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Name | LINDA NWACHUKU
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Credential |
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Telephone | 443-559-4307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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