Provider Demographics
NPI:1750254637
Name:HILDAGARD WELLNESS CENTER, INC.
Entity type:Organization
Organization Name:HILDAGARD WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NONDWE
Authorized Official - Middle Name:MAUD
Authorized Official - Last Name:MAKUBALO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-683-6075
Mailing Address - Street 1:1923 ALICEANNA ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3014
Mailing Address - Country:US
Mailing Address - Phone:443-683-6075
Mailing Address - Fax:
Practice Address - Street 1:518 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-5911
Practice Address - Country:US
Practice Address - Phone:443-683-6075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)