Organization
MARYLAND WELLNESS LLC
Active
Parent organization
MARYLAND WELLNESS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARYLAND WELLNESS LLC
Authorized official
MS. SIERRA BURLEY (CREDENTIALING SPECIALIST)
(410) 314-1030
Entity
Organization
Contact information
Practice address
2255 CRAIN HWY STE 106, WALDORF, MD 20601-3186
(410) 241-6317
Mailing address
4128 HAYWARD AVE # W, BALTIMORE, MD 21215-4340
(410) 241-6317
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220412455
MARYLAND BEHAVIORAL HEALTH ADMINISTRATION
MD
01
—
220412456
MARYLAND BEHAVIORAL HEALTH ADMINISTRATION
MD
01
—
220412457
MARYLAND BEHAVIORAL HEALTH ADMINISTRATION
MD
01
—
220412458
MARYLAND BEHAVIORAL HEALTH ADMINISTRATION
MD
01
—
220412459
MARYLAND BEHAVIORAL HEALTH ADMINISTRATION
MD
Enumeration date
04/29/2021
Last updated
04/16/2025
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