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General NPI Number Information
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NPI Number | 1609480870
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Entity Type | Organization
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Legal Business Name | GREENLAND BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 516 N ROLLING RD
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City | BALTIMORE
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State | MD
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Zip | 21228-4140
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Country | US
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Telephone | 443-453-2044
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Fax |
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Provider Business Mailing Address
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Address Line | 7214 OAK HAVEN CIR APT 303
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City | WINDSOR MILL
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State | MD
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Zip | 21244-3518
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Country | US
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Telephone | 443-453-2044
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | IFEOMA J DUNN
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Credential |
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Telephone | 443-453-2044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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