NPIMap

Organization Active NPI

Montgomery Wellness Hub LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hagerstown, MD
National Provider Identifier
1437972924
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MONTGOMERY WELLNESS HUB LLC
Practice address
6 W Washington St Ste 200
Hagerstown, MD 21740-4830
Phone
(301) 404-7336
NPI assigned
Nov 4, 2024
Organization subpart
Yes
Parent organization
MONTGOMERY WELLNESS HUB LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Mohammed Kolawole Ibrahim
Title
Ceo
Phone
(240) 246-7837

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Community Health Clinic/Center 261QC1500X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

6 W Washington St Ste 200
Hagerstown, MD 21740-4830

Mailing address

951 Russell Ave Ste D
Gaithersburg, MD 20879-3283
Phone (301) 404-7336

Other practice location 1

951 Russell Ave Ste D
Gaithersburg, MD 20879-3283
Phone (301) 404-7336

National Provider Directory

National Provider Directory
Tax ID family
Montgomery Wellness Hub LLC9 organizations share this tax ID, including this one
Part of
Montgomery Wellness Hub LLC

Other organizations with this tax ID 8

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

Locations

951 Russell Ave
Ste D
Gaithersburg, MD 20879
Phone (240) 246-7837

NPI Registry JSON

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1437972924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 RUSSELL AVE STE D",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793283",
            "telephone_number": "301-404-7336",
            "fax_number": "240-246-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 W WASHINGTON ST STE 200",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404830",
            "telephone_number": "301-404-7336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "951 Russell Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208793283",
            "country_code": "US",
            "telephone_number": "301-404-7336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MONTGOMERY WELLNESS HUB LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTGOMERY WELLNESS HUB LLC",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "KOLAWOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-246-7837"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.