Healthcare Provider Details

I. General information

NPI: 1528736386
Provider Name (Legal Business Name): FIRST CHOICE BEHAVIORAL HEALTH SERVICES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2021
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9199 REISTERSTOWN RD STE 105B
OWINGS MILLS MD
21117-4513
US

IV. Provider business mailing address

17 WARREN RD STE 1A
PIKESVILLE MD
21208-5001
US

V. Phone/Fax

Practice location:
  • Phone: 410-989-9922
  • Fax: 410-779-9400
Mailing address:
  • Phone: 410-989-9922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. NADIA SURIN
Title or Position: OWNER
Credential:
Phone: 410-989-9922