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General NPI Number Information
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NPI Number | 1578386462
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Entity Type | Organization
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Legal Business Name | CENTRIA HEALTHCARE LLC
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 6820 HOSPITAL DR STE 100
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City | ROSEDALE
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State | MD
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Zip | 21237-4358
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Country | US
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Telephone | 855-772-8847
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Fax |
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Provider Business Mailing Address
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Address Line | 27777 INKSTER RD STE 100
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-5312
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Country | US
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Telephone | 855-772-8847
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Fax | 248-598-4966
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Authorized Official
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Title or Position | DIRECTOR OF CONTRACT ADMINISTRATION
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Name | MR. DANIEL CORLEY
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Credential |
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Telephone | 248-919-1156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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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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