Organization
VISTA WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID PRIDGEN (PRESIDENT AND CEO)
(443) 506-0709
Entity
Organization
Contact information
Practice address
1829 REISTERSTOWN RD STE 350, PIKESVILLE, MD 21208-7126
(443) 506-0709
Mailing address
1829 REISTERSTOWN RD STE 350, PIKESVILLE, MD 21208-7126
(443) 506-0709
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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