Healthcare Provider Details

I. General information

NPI: 1932523008
Provider Name (Legal Business Name): TEMAH HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 SCOTT ADAM RD STE 204
COCKEYSVILLE MD
21030-3295
US

IV. Provider business mailing address

4320 BROOKSIDE OAKS ROAD
OWINGS MILLS MD
21117-5169
US

V. Phone/Fax

Practice location:
  • Phone: 410-521-8000
  • Fax: 410-655-5826
Mailing address:
  • Phone: 410-702-5397
  • Fax: 410-655-5826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR3573
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. GBENGA WILLIAMS
Title or Position: ADMINISTRATOR
Credential:
Phone: 410-521-8000