Healthcare Provider Details

I. General information

NPI: 1497687073
Provider Name (Legal Business Name): AMEND BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3403 WALBROOK AVE
BALTIMORE MD
21216-3042
US

IV. Provider business mailing address

5237 REISTERSTOWN RD
BALTIMORE MD
21215-5018
US

V. Phone/Fax

Practice location:
  • Phone: 240-644-3060
  • Fax:
Mailing address:
  • Phone: 240-644-3060
  • 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 Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. EBELE OLI
Title or Position: DIRECTOR
Credential: DHA
Phone: 240-644-3060