MEDICARE: AMARA HOUSE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1568971695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMARA HOUSE LLC

Provider Business Mailing Address
First Line	:	4557 HIDDEN STREAM CT
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4837
Country	:	US
Telephone Number	:	804-691-7959
Fax Number	:

Provider Business Practice Location Address
First Line	:	4557 HIDDEN STREAM CT
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4837
Country	:	US
Telephone Number	:	804-691-7959
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ASHTON BROWN
Credential	:
Telephone Number	:	804-691-7959

Provider Enumeration Date	:	09/20/2017
Last Update Date	:	07/21/2022

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