Healthcare Provider Details

I. General information

NPI: 1699463703
Provider Name (Legal Business Name): JAY CARE MENTAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8508 LOCH RAVEN BLVD STE E
TOWSON MD
21286-2354
US

IV. Provider business mailing address

8508 LOCH RAVEN BLVD STE E
TOWSON MD
21286-2354
US

V. Phone/Fax

Practice location:
  • Phone: 443-275-2354
  • Fax: 410-853-7263
Mailing address:
  • Phone: 443-275-2354
  • Fax: 410-853-7263

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
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. CHINYERE MABLE OBI
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 443-985-4976