Provider Demographics
NPI:1013486620
Name:TNAT HOLISTIC WELLNESS CENTER
Entity Type:Organization
Organization Name:TNAT HOLISTIC WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:LORENZO
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MS, LGPC, NCC
Authorized Official - Phone:443-333-2970
Mailing Address - Street 1:1652 WINFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-3610
Mailing Address - Country:US
Mailing Address - Phone:443-333-2970
Mailing Address - Fax:
Practice Address - Street 1:3221 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1242
Practice Address - Country:US
Practice Address - Phone:443-333-2970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty