Healthcare Provider Details

I. General information

NPI: 1881426336
Provider Name (Legal Business Name): DMV COMMUNITY HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 WILKENS AVE STE 300
BALTIMORE MD
21229-5214
US

IV. Provider business mailing address

3455 WILKENS AVE STE 300
BALTIMORE MD
21229-5214
US

V. Phone/Fax

Practice location:
  • Phone: 410-989-3225
  • Fax: 443-378-8563
Mailing address:
  • Phone: 410-989-3225
  • Fax: 443-378-8563

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 Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CATHY LORAINE LEMON
Title or Position: CEO
Credential:
Phone: 443-622-2762