# HEALTH RELEAF LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Self
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770255291
- **Authorized official:** DONNA BOATMAN (CREDENTIALING MANAGER)
- **Authorized official phone:** (301) 399-6874

## Contact information

- **Practice address:** 1406B CRAIN HWY S STE 304, GLEN BURNIE, MD 21061-4094
- **Practice address phone:** (301) 804-0344
- **Mailing address:** 1406B CRAIN HWY S STE 304, GLEN BURNIE, MD 21061-4094
- **Mailing address phone:** (301) 804-0344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/03/2021
- **Last updated:** 12/19/2022