# ENERGY BASE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sage Chi Integrative Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912587239
- **Authorized official:** DR. TIAA C. HARTLEY D.AC, L.AC (OWNER)
- **Authorized official phone:** (301) 580-4585

## Contact information

- **Practice address:** 1629 CROFTON CTR STE 18, CROFTON, MD 21114-1318
- **Practice address phone:** (301) 580-4585
- **Practice address fax:** (240) 366-5954
- **Mailing address:** 1123 STATE ROUTE 3 N STE 282, GAMBRILLS, MD 21054-1715
- **Mailing address phone:** (301) 580-4585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | — | Yes |
| 171400000X | Health & Wellness Coach | — | — | — |

## Other

- **Enumeration date:** 04/12/2021
- **Last updated:** 09/28/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 764013700 | — | MD |