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General NPI Number Information
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NPI Number | 1790390169
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Entity Type | Organization
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Legal Business Name | ABSOLUTE WELLNESS SERVICES LLC
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Dates
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Enumeration Date | 09/12/2020
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 3700 LIBERTY HEIGHTS AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-7117
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Country | US
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Telephone | 443-712-3202
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Fax |
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Provider Business Mailing Address
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Address Line | 3 WHISPERING CT
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City | OWINGS MILLS
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State | MD
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Zip | 21117-2468
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Country | US
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Telephone | 443-898-2621
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING ATTORNEY
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Name | KARLA MOSES
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Credential | ESQ
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Telephone | 443-500-3202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 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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