Healthcare Provider Details

I. General information

NPI: 1902417249
Provider Name (Legal Business Name): HEALING HANDS BEHAVIORAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14240 W SIDE BLVD APT 205
LAUREL MD
20707-6237
US

IV. Provider business mailing address

14240 W SIDE BLVD APT 205
LAUREL MD
20707-6237
US

V. Phone/Fax

Practice location:
  • Phone: 144-380-3483
  • Fax:
Mailing address:
  • Phone: 144-380-3483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. ERIC ANGEME AMENE
Title or Position: OWNER
Credential: PMHNP
Phone: 443-803-4837