MEDICARE: NEW VISION BEHAVIORAL HEALTH SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1861963498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW VISION BEHAVIORAL HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	5718 HARFORD RD STE 103
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21214-2239
Country	:	US
Telephone Number	:	410-254-4343
Fax Number	:	410-254-4342

Provider Business Practice Location Address
First Line	:	4710 PENNINGTON AVE
Second Line	:	2ND FL, SUITE 3
City	:	CURTIS BAY
State	:	MD
Zip	:	21226-1405
Country	:	US
Telephone Number	:	410-355-3285
Fax Number	:	410-355-1382

Authorized Official
Title or Position	:	CEO/PROGRAM DIRECTOR
Name	:	MRS. CARMEN CASTANG
Credential	:
Telephone Number	:	410-254-4343

Provider Enumeration Date	:	12/07/2018
Last Update Date	:	12/07/2018

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