Provider Demographics
NPI:1083373294
Name:JUST NICE WELLNESS LLC
Entity Type:Organization
Organization Name:JUST NICE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MINOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-424-2401
Mailing Address - Street 1:9613 HARFORD RD STE C
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2150
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9613 HARFORD RD STE C
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-2150
Practice Address - Country:US
Practice Address - Phone:443-424-2401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)