Healthcare Provider Details

I. General information

NPI: 1861963498
Provider Name (Legal Business Name): NEW VISION BEHAVIORAL HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2018
Last Update Date: 12/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 PENNINGTON AVE 2ND FL, SUITE 3
CURTIS BAY MD
21226-1405
US

IV. Provider business mailing address

5718 HARFORD RD STE 103
BALTIMORE MD
21214-2239
US

V. Phone/Fax

Practice location:
  • Phone: 410-355-3285
  • Fax: 410-355-1382
Mailing address:
  • Phone: 410-254-4343
  • Fax: 410-254-4342

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: MRS. CARMEN CASTANG
Title or Position: CEO/PROGRAM DIRECTOR
Credential:
Phone: 410-254-4343