Healthcare Provider Details

I. General information

NPI: 1801712500
Provider Name (Legal Business Name): TEMAH HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 N KENWOOD AVE
BALTIMORE MD
21205-1716
US

IV. Provider business mailing address

4320 BROOKSIDE OAKS
OWINGS MILLS MD
21117-5169
US

V. Phone/Fax

Practice location:
  • Phone: 410-521-8000
  • Fax: 410-655-5826
Mailing address:
  • Phone: 410-521-8000
  • Fax: 410-655-5826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: TEMITOPE S WILLIAMS
Title or Position: PROGRAM DIRECTOR
Credential: PMHNP, FNP-BC
Phone: 410-521-8000