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General NPI Number Information
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NPI Number | 1942013628
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Entity Type | Organization
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Legal Business Name | VENI VIDI VICI TREATMENT SERVICES, LLC
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 4B NORTH AVE STE 303
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City | BEL AIR
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State | MD
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Zip | 21014-2300
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Country | US
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Telephone | 443-819-3172
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Fax | 443-440-5128
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Provider Business Mailing Address
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Address Line | 4B NORTH AVE STE 303
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City | BEL AIR
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State | MD
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Zip | 21014-2300
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Country | US
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Telephone | 443-819-3172
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Fax | 443-440-5128
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Authorized Official
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Title or Position | OWNER/PROGRAM DIRECTOR
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Name | ANASTASIA OBRIEN
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Credential |
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Telephone | 410-937-3468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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