Healthcare Provider Details

I. General information

NPI: 1659244564
Provider Name (Legal Business Name): BLACKSTAR SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 02/08/2026
Certification Date: 02/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10451 MILL RUN CIR STE 452
OWINGS MILLS MD
21117-5577
US

IV. Provider business mailing address

10451 MILL RUN CIR STE 452
OWINGS MILLS MD
21117-5577
US

V. Phone/Fax

Practice location:
  • Phone: 667-392-0170
  • Fax:
Mailing address:
  • Phone: 667-392-0671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
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: NICOLE NUGENT- NUGENT-GYESIE
Title or Position: DIRECTOR
Credential:
Phone: 667-392-0170