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General NPI Number Information
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NPI Number | 1700124831
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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 | 10/19/2020
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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 | 21617-1835
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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 | 106 LEE ST
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City | SALISBURY
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State | MD
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Zip | 21804-5938
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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 | ADMINISTRATOR
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Name | NIRANJAN N JANI
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Credential |
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Telephone | 410-997-5500
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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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