Healthcare Provider Details

I. General information

NPI: 1043159148
Provider Name (Legal Business Name): SUNNYSIDE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3623 FALLS RD
BALTIMORE MD
21211-1815
US

IV. Provider business mailing address

3623 FALLS RD
BALTIMORE MD
21211-1815
US

V. Phone/Fax

Practice location:
  • Phone: 443-915-9061
  • Fax:
Mailing address:
  • Phone: 443-915-9061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. RODNEY BROOKS
Title or Position: CEO
Credential:
Phone: 443-970-0281