Provider Demographics
NPI:1790329894
Name:COMPLETE WELLNESS RECOVERY, INC
Entity Type:Organization
Organization Name:COMPLETE WELLNESS RECOVERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DURWOOD
Authorized Official - Last Name:WHITTEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-438-7863
Mailing Address - Street 1:10 W MADISON ST STE 11
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-2313
Mailing Address - Country:US
Mailing Address - Phone:443-438-7863
Mailing Address - Fax:443-957-9485
Practice Address - Street 1:11 1/2 W CHASE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5473
Practice Address - Country:US
Practice Address - Phone:443-961-3050
Practice Address - Fax:443-957-9485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-31
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility