Healthcare Provider Details

I. General information

NPI: 1922506302
Provider Name (Legal Business Name): HARWOOD BEHAVIORAL HEALTH PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2018
Last Update Date: 01/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SCHOLLS LN
FREDERICK MD
21701-6380
US

IV. Provider business mailing address

428 E 25TH ST
BALTIMORE MD
21218-5304
US

V. Phone/Fax

Practice location:
  • Phone: 410-617-0142
  • Fax:
Mailing address:
  • Phone: 667-239-3263
  • Fax: 443-563-5143

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
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: CYNTHIA C ROBERSON
Title or Position: COMPLIANCE DIRECTOR
Credential: MSW
Phone: 667-239-3263