Healthcare Provider Details

I. General information

NPI: 1942158902
Provider Name (Legal Business Name): PEACEFUL BEHAVIORAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5884 BELAIR RD
BALTIMORE MD
21206-2612
US

IV. Provider business mailing address

5884 BELAIR RD
BALTIMORE MD
21206-2612
US

V. Phone/Fax

Practice location:
  • Phone: 443-791-0678
  • Fax:
Mailing address:
  • Phone: 443-791-0678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KELECHI AGUGUO
Title or Position: CEO
Credential:
Phone: 443-791-0678