Provider Demographics
NPI:1831823574
Name:MORELIFE SOLUTIONS MENTAL HEALTH LLC
Entity type:Organization
Organization Name:MORELIFE SOLUTIONS MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CADE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:410-615-3385
Mailing Address - Street 1:626 OTTER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-3604
Mailing Address - Country:US
Mailing Address - Phone:667-201-3790
Mailing Address - Fax:
Practice Address - Street 1:5335 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-4401
Practice Address - Country:US
Practice Address - Phone:667-201-3790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-09
Last Update Date:2022-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR181282OtherLICENSE