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General NPI Number Information
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NPI Number | 1992375562
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Entity Type | Organization
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Legal Business Name | THE CHANCE HEALTHCARE SERVICES
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 2300 GARRISON BLVD STE 205
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City | BALTIMORE
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State | MD
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Zip | 21216-2309
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Country | US
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Telephone | 443-691-5498
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Fax |
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Provider Business Mailing Address
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Address Line | 9620 MAXWELL RD
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-3792
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Country | US
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Telephone | 443-691-5498
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ITORO E ABATAI
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Credential | PMHNP
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Telephone | 443-691-5498
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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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Taxonomy #2
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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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