| Blacksoleheeling, Llc | |
|
2807 Pinewood Dr Waldorf MD 20601-3047 | |
| (240) 725-2727 | |
| Not Available |
| Full Name | Blacksoleheeling, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2807 Pinewood Dr, Waldorf, Maryland |
| Authorized Official Name and Position | Donnika Jenkins (CFO) |
| Authorized Official Contact | 2407252727 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blacksoleheeling, Llc 5942 Southern Ave Se Washington DC 20019-6553 Ph: () - | Blacksoleheeling, Llc 2807 Pinewood Dr Waldorf MD 20601-3047 Ph: (240) 725-2727 |
| NPI Number | 1912627811 |
|---|---|
| Provider Enumeration Date | 08/31/2022 |
| Last Update Date | 08/31/2022 |
| Certification Date | 08/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912627811 | NPI | - | NPPES |
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