| Infinite Growth Life And Wellness Llc | |
|
6600 York Rd Ste 109a Baltimore MD 21212-2092 | |
| (443) 848-4335 | |
| Not Available |
| Full Name | Infinite Growth Life And Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6600 York Rd Ste 109a, Baltimore, Maryland |
| Authorized Official Name and Position | Tyvangela Christine Hopkins (OWNER/PROVIDER) |
| Authorized Official Contact | 4438484335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infinite Growth Life And Wellness Llc P.o Box 31730 Gwynn Oak MD 21207-9998 Ph: (443) 848-4335 | Infinite Growth Life And Wellness Llc 6600 York Rd Ste 109a Baltimore MD 21212-2092 Ph: (443) 848-4335 |
| NPI Number | 1821515008 |
|---|---|
| Provider Enumeration Date | 08/28/2017 |
| Last Update Date | 11/14/2020 |
| Certification Date | 11/14/2020 |
| Medicare PECOS PAC ID | 8123439205 |
|---|---|
| Medicare Enrollment ID | O20201120001080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821515008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 20031 (Maryland) | Primary |
| Provider Name | Tyvangela Christine Hopkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174061634 PECOS PAC ID: 9032520119 Enrollment ID: I20201120001573 |
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