Healthcare Provider Details

I. General information

NPI: 1982583647
Provider Name (Legal Business Name): LIVING SPRING BEHAVIORAL HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9717 BON HAVEN LN
OWINGS MILLS MD
21117-7410
US

IV. Provider business mailing address

9717 BON HAVEN LN
OWINGS MILLS MD
21117-7410
US

V. Phone/Fax

Practice location:
  • Phone: 443-929-5350
  • Fax:
Mailing address:
  • Phone: 443-929-5350
  • Fax: 410-356-3542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. BIMPE O ADEDO
Title or Position: MEDICAL DIRECTOR
Credential: NURSE PRACTIONER
Phone: 443-929-5350