MEDICARE: AGATE INTEGRATED AND BEHAVIORAL HEALTHCARE SERVICES INC

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	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1770466849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGATE INTEGRATED AND BEHAVIORAL HEALTHCARE SERVICES INC

Provider Business Mailing Address
First Line	:	3216 GREENMOUNT AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-3438
Country	:	US
Telephone Number	:	443-934-0084
Fax Number	:

Provider Business Practice Location Address
First Line	:	3218 GREENMOUNT AVENUE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218
Country	:	US
Telephone Number	:	443-934-0084
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JIMOH A ADEBAYO
Credential	:
Telephone Number	:	240-515-4868

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	01/12/2026

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