NPIMap

Organization Active NPI

Maryland Wellness LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cumberland, MD
National Provider Identifier
1649986159
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MARYLAND WELLNESS LLC
Practice address
519 N Mechanic St
Cumberland, MD 21502-2133
Phone
(410) 314-1030
Fax
(410) 314-1030
NPI assigned
Jan 27, 2023
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Casey Wu
Title
Director
Phone
(214) 659-1503

National Provider Directory

National Provider Directory
Tax ID family
Maryland Wellness LLC39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

NPPES NPI Registry

Primary practice location

519 N Mechanic St
Cumberland, MD 21502-2133

Mailing address

4128 Hayward Ave
Baltimore, MD 21215-4340
Phone (410) 314-1030

Other practice location 1

4128 Hayward Ave
Baltimore, MD 21215-4340
Phone (410) 314-1030

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
220412448OtherMDMD DEPARTMENT OF HEALTH - LEVEL 1 - OUTPATIENT TREATMENT PROGRAM - ADULTS
220412449OtherMDMD DEPARTMENT OF HEALTH - LEVEL 2.1 - INTENSIVE OUTPATIENT TREATMENT PROGRAM

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 30, 2023.

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1649986159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 HAYWARD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212154340",
            "telephone_number": "410-314-1030",
            "fax_number": "410-314-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 N MECHANIC ST",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022133",
            "telephone_number": "410-314-1030",
            "fax_number": "410-314-1030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4128 Hayward Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212154340",
            "country_code": "US",
            "telephone_number": "410-314-1030",
            "fax_number": "410-314-1030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARYLAND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "214-659-1503"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD DEPARTMENT OF HEALTH - LEVEL 1 - OUTPATIENT TREATMENT PROGRAM - ADULTS",
            "identifier": "220412448",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD DEPARTMENT OF HEALTH - LEVEL 2.1 - INTENSIVE OUTPATIENT TREATMENT PROGRAM",
            "identifier": "220412449",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.