NPIMap

Organization Active NPI

The Elysian Fields Optimum Wellness and Mental Health Group, LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1225672314
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
3401 Elgin Ave
Baltimore, MD 21216-2605
Phone
(410) 624-5037
NPI assigned
Oct 31, 2019
Last updated
Feb 10, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
THE ELYSIAN FIELDS OPTIMUM WELLNESS AND MENTAL HEALTH GROUP, LLCAs 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
Ceo
Phone
(410) 367-0708

Specialties & licenses 1

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

Addresses

Primary practice location

3401 Elgin Ave
Baltimore, MD 21216-2605

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@70x7wm.com Direct

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 Optimum Wellness and Mental Health Group LLC12 organizations share this tax ID, including this one
Part of
The Elysian Fields Optimum Wellness and Mental Health Group LLC

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675987200000",
    "number": "1225672314",
    "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": "3401 ELGIN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162605",
            "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": "THE ELYSIAN FIELDS OPTIMUM WELLNESS AND MENTAL HEALTH GROUP, LLC",
        "enumeration_date": "2019-10-31",
        "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": "CEO",
        "authorized_official_telephone_number": "410-367-0708"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@70x7wm.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "3401 Elgin Ave",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212162605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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.