BORNFREE WELLNESS CENTERS OF AMERICA (NPI# 1417409160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417409160 |
| Entity Type | Organization |
| Organization Name | BORNFREE WELLNESS CENTERS OF AMERICA |
| Practice Address |
19537 Doctor's Drive Germantown MD 20874 |
| Mailing Address |
19537 Doctors Dr Germantown MD 20874-5262 |
| Practice Telephone | 3014535111 |
| Practice Fax Number | 7038806378 |
| Mailing Telephone | 2406544001 |
| Mailing Fax Number | 2406544190 |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2020-03-09 |
| Authorized Official Name | MS. MAHEEN NASIM (PROGRAM SPONSOR) |
| Authorized Official Telephone | 7039898000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 1417409160 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | BornFree Wellness Centers of America LLC | 19537 Doctor'S Drive, Germantown, Maryland 20874 |
| Street Address |
19537 DOCTOR'S DRIVE |
| City | GERMANTOWN |
| State | MD |
| Zip Code | 20874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768973 | Lauren Grace Dovin | Speech-Language Pathologist | 18501 Cinnamon Dr. Germantown, Germantown, MD 20874 | 2019-09-04 |
| 1578119376 | Kevin Crippen | Speech-Language Pathologist | Seneca Valley High School, 19401 Crystal Rock Drive, Germantown, MD 20874 | 2019-08-16 |
| 1245700830 | Heather Macvean | Behavioral Analyst | 18100 Chalet Dr Apt 301, Germantown, MD 20874 | 2018-11-27 |
| 1811414014 | Wanai Sen Kum | Pharmacist | 12825 Westeria Drive, Germantown, MD 20874 | 2017-08-28 |
| 1396119210 | Darling St Louis | Social Worker | 18936 Port Haven Pl, Germantown, MD 20874 | 2015-11-16 |
| 1003289067 | Olayiwola O Oloko | Home Health Aide | 19300 Circle Gate Dr #201, Germantown, MD 20874 | 2015-11-12 |
| 1831562446 | Joanne Croos | Physical Therapist | 13905 Briarwick St, Germantown, MD 20874 | 2015-11-04 |
| 1255717070 | Caring Health Services Inc | Case Management | 12312 Quail Woods Dr, Germantown, MD 20874 | 2015-08-04 |
| 1184007817 | Mobile Medical Care, Inc. | Clinic/Center | 981 Rollins Ave., Rockville, MD 20874 | 2015-06-30 |
| 1841680915 | Angela Leah Novas | Nurse Practitioner | 19745 Executive Park Circle, Advanced Medical Care, Germantown, MD 20874 | 2015-01-28 |
| Find all providers in zip 20874 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477151066 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 486 Lincoln Dr, Glen Burnie, MD 21060-8706 | 2020-10-15 |
| 1841898434 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 394 Washington Ave, Glen Burnie, MD 21060-8712 | 2020-10-15 |
| 1942808050 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 10 S Broadway, Baltimore, MD 21231-1775 | 2020-10-12 |
| 1396343414 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 15 S Broadway, Baltimore, MD 21231-1714 | 2020-10-12 |
| 1801494984 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 8315 Veterans Hwy, Millersville, MD 21108-1421 | 2020-10-12 |
| 1124626296 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 390 Washington Ave, Glen Burnie, MD 21060-8712 | 2020-10-12 |
| 1457968984 | Powell Recovery Center | Substance Abuse Rehabilitation Facility | 22 S Broadway, Baltimore, MD 21231-1711 | 2020-09-29 |
| 1356956676 | The Elysian Fields Optimum Wellness and Mental Health Group, LLC | Substance Abuse Rehabilitation Facility | 2901 Erdman Ave, Baltimore, MD 21213-1139 | 2020-09-14 |
| 1134731284 | Serenity Keepers of Maryland LLC | Substance Abuse Rehabilitation Facility | 3645 Cottage Ave, Baltimore, MD 21215-7725 | 2020-08-20 |
| 1255949392 | Champ House Recovery Inc. | Substance Abuse Rehabilitation Facility | 8655 Normal School Rd, Bowie, MD 20715-3326 | 2020-07-15 |
| Find all providers with the same taxonomy | ||||
| City | GERMANTOWN |
| Zip Code | 20874 |
Please comment or provide details below to improve the information on BORNFREE WELLNESS CENTERS OF AMERICA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.