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General NPI Number Information
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NPI Number | 1235051046
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Entity Type | Organization
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Legal Business Name | GRATEFUL MIND WELLNESS & BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 8641 LOCH RAVEN BLVD STE 3A3B
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City | TOWSON
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State | MD
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Zip | 21286-2310
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Country | US
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Telephone | 443-992-5313
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Fax |
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Provider Business Mailing Address
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Address Line | 8641 LOCH RAVEN BLVD STE 3A3B
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City | TOWSON
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State | MD
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Zip | 21286-2310
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Country | US
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Telephone | 443-992-5313
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGING MEMBER
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Name | CARLINE BEVERLY
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Credential | RN, BSN
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Telephone | 443-992-5313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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