NPIMap

Organization Active NPI

The Elysian Fields Optimum Wellness and Mental Health Group, LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1124671714
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
THE ELYSIAN FIELDS OPTIMUM WELLNESS AND MENTAL HEALTH GROUP, LLC
Practice address
3307 Henry G Parks Jr Cir
Baltimore, MD 21215-7998
Phone
(410) 624-5037
NPI assigned
Jul 22, 2019
Organization subpart
Yes
Parent organization
ELYSIAN FIELDS OPTIMUM WELLNESSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Arthur Griffin
Title
Owner
Phone
(410) 367-0708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

3307 Henry G Parks Jr Cir
Baltimore, MD 21215-7998

Mailing address

2222 N Howard St
Baltimore, MD 21218-5609
Phone (410) 624-5037

Other names 1

  • The Seventy Times Seven Wellness Mission Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@70x7wm.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230726002222 MD Part B Supplier - Clinic/Group Practice 8426419235 Receives reassigned benefits from 1 practitioner
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baltimore, MD

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
The Elysian Fields Optimum12 organizations share this tax ID, including this one
Part of
The Elysian Fields Optimum

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675987200000",
    "number": "1124671714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N HOWARD ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185609",
            "telephone_number": "410-624-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 HENRY G PARKS JR CIR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212157998",
            "telephone_number": "410-624-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ELYSIAN FIELDS OPTIMUM WELLNESS AND MENTAL HEALTH GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELYSIAN FIELDS OPTIMUM WELLNESS",
        "enumeration_date": "2019-07-22",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-367-0708"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@70x7wm.com",
            "affiliation": "N",
            "address_1": "3307 Henry G Parks Jr Cir",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212157998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Seventy Times Seven Wellness Mission",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Seventy Times Seven Wellness Mission",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.