Healthcare Provider Details

I. General information

NPI: 1871999276
Provider Name (Legal Business Name): BERGAND GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2014
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 HARFORD RD
FALLSTON MD
21047
US

IV. Provider business mailing address

1803 HARFORD RD
FALLSTON MD
21047-2501
US

V. Phone/Fax

Practice location:
  • Phone: 410-853-7691
  • Fax: 443-519-5167
Mailing address:
  • Phone: 410-853-7691
  • Fax: 443-519-5167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN COX
Title or Position: EXECUTIVE
Credential:
Phone: 410-853-7691