Healthcare Provider Details

I. General information

NPI: 1245833797
Provider Name (Legal Business Name): FUTURE HOPE BEHAVIORAL MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 YORK ROAD SUITE 800 LTR 14
LUTHERVILLE MD
21093
US

IV. Provider business mailing address

1924 ELLINWOOD RD
BALTIMORE MD
21237-1914
US

V. Phone/Fax

Practice location:
  • Phone: 443-928-5306
  • Fax:
Mailing address:
  • Phone: 443-928-5306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GABRIEL M JIABANA
Title or Position: CEO
Credential: PHD
Phone: 443-928-5306