Baltimore Wellness Group LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BALTIMORE WELLNESS GROUP LLC

Practice address

1013 W Lafayette Ave Ste 1
Baltimore, MD 21217-2556

Phone

(410) 428-9563

NPI assigned

Aug 3, 2023

Organization subpart

No

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

Authorized official

Name

Mr. King Awonusi II

Title

President

Phone

(410) 428-9563

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1194407759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 W LAFAYETTE AVE STE 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212172556",
            "telephone_number": "410-428-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 W LAFAYETTE AVE STE 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212172556",
            "telephone_number": "410-428-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALTIMORE WELLNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "AWONUSI",
        "authorized_official_first_name": "KING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-428-9563",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.