Organization
BLACKSOLEHEELING, LLC
Active
Other names
BSH, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DONNIKA JENKINS NCC, LPC (CFO)
(240) 725-2727
Entity
Organization
Contact information
Practice address
2807 PINEWOOD DR, WALDORF, MD 20601-3047
(240) 725-2727
Mailing address
5942 SOUTHERN AVE SE, WASHINGTON, DC 20019-6553
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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