Healthcare Provider Details
I. General information
NPI: 1558111872
Provider Name (Legal Business Name): RISING ABOVE BEHAVIORAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1719 W LEXINGTON ST
BALTIMORE MD
21223-1633
US
IV. Provider business mailing address
3809 S HANOVER ST
BALTIMORE MD
21225-1708
US
V. Phone/Fax
- Phone: 443-621-9208
- Fax:
- Phone: 443-621-9208
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 177F00000X |
| Taxonomy | Lodging Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 276400000X |
| Taxonomy | Substance Use Disorder Rehabilitation Hospital Unit |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
FRANKLIN
JOSEPH
BECK
Title or Position: OWNER
Credential: LCADC
Phone: 443-621-9208