Healthcare Provider Details

I. General information

NPI: 1821928011
Provider Name (Legal Business Name): JOY EVERLASTING PSYCHIATRIC REHABILITATION PROGRAM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23-25 E NORTH AVE UPPER LEVEL 2
BALTIMORE MD
21202
US

IV. Provider business mailing address

1635 EDMONDSON AVE
BALTIMORE MD
21223-1264
US

V. Phone/Fax

Practice location:
  • Phone: 443-520-1437
  • Fax:
Mailing address:
  • Phone: 443-520-1437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JOY EVERLASTING
Title or Position: CEO
Credential: N/A
Phone: 443-520-1437