Healthcare Provider Details

I. General information

NPI: 1265104830
Provider Name (Legal Business Name): PUDDIN HELPING HANDS MENTAL & BEHAVIORAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 LEE RD
CHESTER MD
21619-2708
US

IV. Provider business mailing address

111 LEE RD
CHESTER MD
21619-2708
US

V. Phone/Fax

Practice location:
  • Phone: 443-652-2152
  • Fax:
Mailing address:
  • Phone: 443-652-2152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SIDNEY NEVILLE
Title or Position: PRESIDENT
Credential:
Phone: 443-652-2152