Healthcare Provider Details

I. General information

NPI: 1619687100
Provider Name (Legal Business Name): 925 GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2022
Last Update Date: 08/03/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4017 GILL AVE STE 1-4
HAMPSTEAD MD
21074-2264
US

IV. Provider business mailing address

942 MAGNOLIA BLOSSOM CT
SYKESVILLE MD
21784-7688
US

V. Phone/Fax

Practice location:
  • Phone: 443-777-0925
  • Fax:
Mailing address:
  • Phone: 443-890-4309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MISS MELISSA J MCCARTHY
Title or Position: MANAGING PARTNER
Credential:
Phone: 443-890-4309