Healthcare Provider Details

I. General information

NPI: 1770308975
Provider Name (Legal Business Name): DELUXE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 N ROLLING RD STE 108
CATONSVILLE MD
21228-4141
US

IV. Provider business mailing address

15005 JERIMIAH LN
BOWIE MD
20721-7224
US

V. Phone/Fax

Practice location:
  • Phone: 301-801-0427
  • Fax:
Mailing address:
  • Phone: 301-801-0427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: HYCENTA HALLE
Title or Position: OWNER AUTHORIZED OFFICIAL
Credential: CRNP-PMH
Phone: 301-801-0427