Healthcare Provider Details

I. General information

NPI: 1952198921
Provider Name (Legal Business Name): AMANA HEALTH & RESOURCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 SWANBRIDGE CT
WINDSOR MILL MD
21244-1964
US

IV. Provider business mailing address

9722 GROFFS MILL DR # 30030
OWINGS MILLS MD
21117-6341
US

V. Phone/Fax

Practice location:
  • Phone: 443-977-2579
  • Fax:
Mailing address:
  • Phone: 202-573-7641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. TYREECE GENEAN JOHNSON
Title or Position: OWNER
Credential:
Phone: 443-977-2579