Healthcare Provider Details

I. General information

NPI: 1356296073
Provider Name (Legal Business Name): HOPEBRIDGE BEHAVIORAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 HANOVER PKWY # B206
GREENBELT MD
20770-2010
US

IV. Provider business mailing address

10225 WINDSOR OAKS WAY
LANHAM MD
20706-2572
US

V. Phone/Fax

Practice location:
  • Phone: 310-890-8104
  • Fax:
Mailing address:
  • Phone: 310-890-8104
  • Fax: 310-890-8104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. MUMTAZ SADIQUE MUMTAZ SADIQUE
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 310-890-8104