Bisa Wellness Center LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BISA WELLNESS CENTER LLC

Practice address

493 Main St
Prince Frederick, MD 20678-3186

Phone

(208) 409-2566

NPI assigned

Aug 24, 2026

Last updated

Aug 24, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Endysen Atu

Title

Director

Phone

(208) 409-2566

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1787529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787529600000",
    "number": "1659287175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 MAIN ST",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783186",
            "telephone_number": "208-409-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 MAIN ST",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783186",
            "telephone_number": "208-409-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BISA WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-24",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A",
        "authorized_official_last_name": "ATU",
        "authorized_official_first_name": "ENDYSEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-409-2566"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott A Berube, OT
• Charlotte Betteridge
• Jennifer Bevard
• Bhargesh P. Mehta, M.D., P.a.
• Ervind Sriram Bhogte, M.D.
• Elizabeth Anne Bissett, CRNP
• Gwendolyn Marcella Blacknall, LGADC
• Elizabeth Ann Blank, M.D.
• Amy Christine Bolger, PHARM D
• Bollich, LLC

• Community/Behavioral Health Agency in Prince Frederick, MD
• Providers in Prince Frederick, 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 24, 2026; 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.