Healthcare Provider Details

I. General information

NPI: 1063072957
Provider Name (Legal Business Name): HARVEST OF HOPE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 02/07/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 MAIDEN CHOICE LN
CATONSVILLE MD
21228-5940
US

IV. Provider business mailing address

720 MAIDEN CHOICE LN # CONDOC
CATONSVILLE MD
21228-5940
US

V. Phone/Fax

Practice location:
  • Phone: 443-334-5732
  • Fax: 443-334-5738
Mailing address:
  • Phone: 443-334-5732
  • Fax: 443-334-5738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROBIN LAWRENCE
Title or Position: CEO
Credential: BSP
Phone: 443-334-5732