Organization
LIFES ENERGY WELLNESS CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA MARIA KELLEY-FREEMAN (CEO)
(800) 867-2395
Entity
Organization
Contact information
Practice address
2324 N ZION RD STE 112, SALISBURY, MD 21801-2575
(800) 867-2395
(410) 443-0842
Mailing address
PO BOX 123, EASTON, MD 21601-8901
(800) 867-2395
(410) 443-0842
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2324112
—
MD
Enumeration date
12/07/2021
Last updated
12/07/2021
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