Healthcare Provider Details

I. General information

NPI: 1518622463
Provider Name (Legal Business Name): AMERI-HOPE MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2021
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 WILKENS AVE STE 209
BALTIMORE MD
21229-5265
US

IV. Provider business mailing address

3455 WILKENS AVE STE 209
BALTIMORE MD
21229-5265
US

V. Phone/Fax

Practice location:
  • Phone: 301-346-3576
  • Fax:
Mailing address:
  • Phone: 301-346-3576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL SOBOWALE
Title or Position: OWNER
Credential:
Phone: 301-346-3576