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General NPI Number Information
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NPI Number | 1609297837
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Entity Type | Organization
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Legal Business Name | BURRIS BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 12/13/2013
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Last Update Date | 12/13/2013
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Provider Practice Location Address
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Address Line | 1200 BRASS MILL RD SUITE A
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City | BELCAMP
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State | MD
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Zip | 21017-1217
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Country | US
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Telephone | 410-935-1489
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 BRASS MILL ROAD SUITE A
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City | BELCAMP
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State | MD
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Zip | 21017
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Country | US
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Telephone | 410-935-1489
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARTHUR BURRIS
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Credential | PHD,LCPC
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Telephone | 410-935-1489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | LC0372
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License Number State | MD
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