| Whole Life Center, Llc | |
|
4324 York Rd Fl 2 Baltimore MD 21212-4846 | |
| (443) 416-8864 | |
| Not Available |
| Full Name | Whole Life Center, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4324 York Rd Fl 2, Baltimore, Maryland |
| Authorized Official Name and Position | Charmeika Lewis (SOCIAL WORKER) |
| Authorized Official Contact | 4434168864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Whole Life Center, Llc 614 N Augusta Ave Baltimore MD 21229-1801 Ph: () - | Whole Life Center, Llc 4324 York Rd Fl 2 Baltimore MD 21212-4846 Ph: (443) 416-8864 |
| NPI Number | 1306488267 |
|---|---|
| Provider Enumeration Date | 10/11/2019 |
| Last Update Date | 10/11/2019 |
| Medicare PECOS PAC ID | 5193140135 |
|---|---|
| Medicare Enrollment ID | O20200807000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306488267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Charmeika Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083067805 PECOS PAC ID: 6800211848 Enrollment ID: I20201001000051 |
| Provider Name | Dana Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760955090 PECOS PAC ID: 7618392655 Enrollment ID: I20201019002599 |
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