Organization
PUSH HEALTH AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH COLLINS (CO-OWNER)
(443) 690-8029
Entity
Organization
Contact information
Practice address
1321 MOUNT HERMON RD # C-1, SALISBURY, MD 21804-5302
(443) 736-8661
Mailing address
1321 MOUNT HERMON RD # C-1, SALISBURY, MD 21804-5302
(443) 736-8661
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22111350
BHA LICENSE
MD
Enumeration date
12/19/2022
Last updated
12/19/2022
Update your record
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