Healthcare Provider Details

I. General information

NPI: 1609297837
Provider Name (Legal Business Name): BURRIS BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2013
Last Update Date: 12/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BRASS MILL RD SUITE A
BELCAMP MD
21017-1217
US

IV. Provider business mailing address

1200 BRASS MILL ROAD SUITE A
BELCAMP MD
21017
US

V. Phone/Fax

Practice location:
  • Phone: 410-935-1489
  • Fax:
Mailing address:
  • Phone: 410-935-1489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberLC0372
License Number StateMD

VIII. Authorized Official

Name: DR. ARTHUR BURRIS
Title or Position: PRESIDENT
Credential: PHD,LCPC
Phone: 410-935-1489