| Jade Health & Wellness, Llc | |
|
3301 Belair Rd Baltimore MD 21213-1257 | |
| (410) 929-3893 | |
| Not Available |
| Full Name | Jade Health & Wellness, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3301 Belair Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Theressa Williams (EXECUTIVE DIRECTOR/CEO) |
| Authorized Official Contact | 4437446214 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jade Health & Wellness, Llc 9627 Eaves Dr Owings Mills MD 21117-5919 Ph: () - | Jade Health & Wellness, Llc 3301 Belair Rd Baltimore MD 21213-1257 Ph: (410) 929-3893 |
| NPI Number | 1902448335 |
|---|---|
| Provider Enumeration Date | 10/17/2019 |
| Last Update Date | 09/24/2020 |
| Medicare PECOS PAC ID | 6103218086 |
|---|---|
| Medicare Enrollment ID | O20220127000057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902448335 | NPI | - | NPPES |
| 1922514348 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Theressa Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922514348 PECOS PAC ID: 1658634688 Enrollment ID: I20180404001564 |
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