MEDICARE: THERAPEUTIC WELLNESS SERVICES CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104490978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC WELLNESS SERVICES CORP

Provider Business Mailing Address
First Line	:	4909 LIBERTY HEIGHTS AVE FL 2
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21207-8235
Country	:	US
Telephone Number	:	443-934-2320
Fax Number	:	410-665-3001

Provider Business Practice Location Address
First Line	:	4909 LIBERTY HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21207-8235
Country	:	US
Telephone Number	:	410-665-3000
Fax Number	:	410-665-3001

Authorized Official
Title or Position	:	OWNER
Name	:	MISS ARTEARA WATKINS
Credential	:
Telephone Number	:	443-934-2320

Provider Enumeration Date	:	05/17/2021
Last Update Date	:	05/05/2022

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Directions to “THERAPEUTIC WELLNESS SERVICES CORP ” Practice Location

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