Healthcare Provider Details

I. General information

NPI: 1871283739
Provider Name (Legal Business Name): AMERICARE THERAPEUTIC CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2327 PENNSYLVANIA AVE
BALTIMORE MD
21217-2827
US

IV. Provider business mailing address

2327 PENNSYLVANIA AVE
BALTIMORE MD
21217-2827
US

V. Phone/Fax

Practice location:
  • Phone: 301-455-9785
  • Fax: 866-450-1117
Mailing address:
  • Phone: 301-455-9785
  • Fax: 866-450-1117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: OLUREMI MICHELLE AYOH
Title or Position: CEO
Credential:
Phone: 301-455-9785