Organization
PEM WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY VALLE LUCAS CRNP (OWNER)
(443) 865-8695
Entity
Organization
Contact information
Practice address
375 CHISELED STONE RD, SYKESVILLE, MD 21784-8656
(443) 865-8695
Mailing address
375 CHISELED STONE RD, SYKESVILLE, MD 21784-8656
(443) 865-8695
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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