Healthcare Provider Details

I. General information

NPI: 1992375562
Provider Name (Legal Business Name): THE CHANCE HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GARRISON BLVD STE 205
BALTIMORE MD
21216-2309
US

IV. Provider business mailing address

9620 MAXWELL RD
MIDDLE RIVER MD
21220-3792
US

V. Phone/Fax

Practice location:
  • Phone: 443-691-5498
  • Fax:
Mailing address:
  • Phone: 443-691-5498
  • Fax:

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 Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ITORO E ABATAI
Title or Position: PRESIDENT
Credential: PMHNP
Phone: 443-691-5498