Organization
PUSH HEALTH AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH T COLLINS (CO-OWNER)
(443) 690-8029
Entity
Organization
Contact information
Practice address
1321 MOUNT HERMON RD # C-1, SALISBURY, MD 21804-5302
(443) 736-8691
Mailing address
1321 MOUNT HERMON RD # C-1, SALISBURY, MD 21804-5302
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22111353
BHA LICENSE NUMBER -PRP
MD
Enumeration date
01/27/2023
Last updated
01/27/2023
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