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General NPI Number Information
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NPI Number | 1558255992
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Entity Type | Organization
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Legal Business Name | THE ERIC GROUP BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1309 COFFEEN AVE STE 1200
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City | SHERIDAN
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State | WY
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Zip | 82801-5777
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Country | US
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Telephone | 202-750-1535
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Fax |
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Provider Business Mailing Address
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Address Line | 5802 ANNAPOLIS RD APT 1003
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City | BLADENSBURG
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State | MD
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Zip | 20710-2077
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Country | US
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Telephone | 202-750-1535
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. HARLAN HARRELL
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Credential | EDD
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Telephone | 202-750-1535
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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