Organization
CHARM CITY WELLNESS COLLABORATIVE, LLC
Active
Other names
Charm City Wellness Collaborative, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MK HABER NP, IBCLC (FOUNDER, LEAD CLINICIAN)
(410) 456-6315
Entity
Organization
Contact information
Practice address
612 SAINT DUNSTANS RD, BALTIMORE, MD 21212-3736
(443) 377-3237
(410) 226-7037
Mailing address
5835 YORK RD # 1073, BALTIMORE, MD 21212-3612
(410) 456-6315
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LN0000X
Neonatal Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112778100
—
MD
Enumeration date
11/29/2023
Last updated
11/29/2023
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