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General NPI Number Information
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NPI Number | 1275871394
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Entity Type | Organization
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Legal Business Name | COMMUNITY BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 01/24/2013
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 202 COURSEVALL DR STE 107
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City | CENTREVILLE
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State | MD
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Zip | 21617-2806
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Country | US
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Telephone | 844-224-5264
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Fax | 888-509-0010
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Provider Business Mailing Address
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Address Line | 426 DORCHESTER AVE
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City | CAMBRIDGE
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State | MD
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Zip | 21613-2446
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Country | US
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Telephone | 443-944-9605
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Fax | 888-509-0010
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Authorized Official
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Title or Position | CHIEF ADMINISTRATOR
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Name | SHYAM BHAYANI
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Credential |
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Telephone | 240-343-5816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | D0037205
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License Number State | MD
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