Healthcare Provider Details

I. General information

NPI: 1043885452
Provider Name (Legal Business Name): CONFIDENCE HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 W BEL AIR AVE STE 6
ABERDEEN MD
21001-3256
US

IV. Provider business mailing address

219 W BEL AIR AVE STE 6
ABERDEEN MD
21001-3256
US

V. Phone/Fax

Practice location:
  • Phone: 443-562-6538
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHIGOZIEM EKWONYE
Title or Position: CEO
Credential:
Phone: 443-562-6538