Provider Demographics
NPI:1174954499
Name:NEIGHBORHOOD WELLNESS, LLC
Entity type:Organization
Organization Name:NEIGHBORHOOD WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:N
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-356-8836
Mailing Address - Street 1:10451 MILL RUN CIRCLE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5594
Mailing Address - Country:US
Mailing Address - Phone:410-356-8836
Mailing Address - Fax:410-356-8804
Practice Address - Street 1:2401 LIBERTY HEIGHTS AVENUE
Practice Address - Street 2:MONDAWMIN MALL, SPACE 4625
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-8086
Practice Address - Country:US
Practice Address - Phone:410-365-7335
Practice Address - Fax:410-383-8959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty