Healthcare Provider Details

I. General information

NPI: 1073262994
Provider Name (Legal Business Name): SUNNYSIDE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2022
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3623 FALLS RD
BALTIMORE MD
21211-1815
US

IV. Provider business mailing address

PO BOX 2915
BALTIMORE MD
21229-0915
US

V. Phone/Fax

Practice location:
  • Phone: 443-970-0281
  • Fax:
Mailing address:
  • Phone: 443-970-0281
  • 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 TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: RODNEY JAMES BROOKS
Title or Position: OWNER
Credential:
Phone: 443-970-0281