Healthcare Provider Details

I. General information

NPI: 1790426070
Provider Name (Legal Business Name): NOAHS ARK BEHAVIORAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2022
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6404 EASTBOURNE AVE
BALTIMORE MD
21224-6201
US

IV. Provider business mailing address

7 COMMERCIAL PLZ
ELKTON MD
21921-5916
US

V. Phone/Fax

Practice location:
  • Phone: 443-255-9670
  • Fax:
Mailing address:
  • Phone: 410-926-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS ELIZABETH BEREZNE
Title or Position: DIRECTOR
Credential:
Phone: 410-926-6262