NPIMap

Organization Active NPI

Montgomery Wellness Hub LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Hagerstown, MD
National Provider Identifier
1588477277
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MONTGOMERY WELLNESS HUB LLC
Practice address
6 W Washington St Ste 200
Hagerstown, MD 21740-4830
Phone
(240) 246-7837
Fax
(240) 246-7911
NPI assigned
Jan 28, 2025
Last updated
Jan 28, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MONTGOMERY WELLNESS HUB LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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
(301) 404-7336

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

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

Mailing address

6 W Washington St Ste 200
Hagerstown, MD 21740-4830
Phone (240) 246-7837

Other names 1

  • Montgomery Wellness Hub LLC, Hagerstown Other name

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.

NPI Registry JSON

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

{
    "created_epoch": "1738022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1588477277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 W WASHINGTON ST STE 200",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404830",
            "telephone_number": "240-246-7837",
            "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": "240-246-7837",
            "fax_number": "240-246-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY WELLNESS HUB LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTGOMERY WELLNESS HUB LLC",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "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": "301-404-7336"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montgomery Wellness Hub LLC, Hagerstown",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 28, 2025; 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.