Healthcare Provider Details

I. General information

NPI: 1336099613
Provider Name (Legal Business Name): AGATE INTEGRATED AND BEHAVIORAL HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3218 GREENMOUNT AVENUE, SECOND FLOOR SECOND FLOOR
BALTIMORE MD
21218
US

IV. Provider business mailing address

3218 GREENMOUNT AVENUE, SECOND FLOOR
BALTIMORE MD
21218
US

V. Phone/Fax

Practice location:
  • Phone: 240-515-4868
  • Fax: 410-275-0466
Mailing address:
  • Phone: 240-515-4868
  • Fax: 410-275-0466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JIMOH A ADEBAYO
Title or Position: CEO
Credential:
Phone: 240-515-4868