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General NPI Number Information
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NPI Number | 1114801396
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Entity Type | Organization
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Legal Business Name | BEYOND MENTAL HEALTH LLC
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 2007 PAULETTE RD APT 203
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City | DUNDALK
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State | MD
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Zip | 21222-5880
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Country | US
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Telephone | 202-300-7616
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Fax |
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Provider Business Mailing Address
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Address Line | 2007 PAULETTE RD APT 203
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City | DUNDALK
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State | MD
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Zip | 21222-5880
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Country | US
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Telephone | 202-300-7616
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DONALT MUTIMURA
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Credential |
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Telephone | 585-685-3561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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