| C. O. A. C. H. Mental Health, Llc | |
|
5 Shawan Rd Ste 101c Hunt Valley MD 21030-1373 | |
| (443) 982-0692 | |
| (443) 982-0610 |
| Full Name | C. O. A. C. H. Mental Health, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5 Shawan Rd Ste 101c, Hunt Valley, Maryland |
| Authorized Official Name and Position | Dwayne Green (OWNER) |
| Authorized Official Contact | 4435066313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C. O. A. C. H. Mental Health, Llc 5 Shawan Rd Ste 101c Hunt Valley MD 21030-1373 Ph: (443) 982-0692 | C. O. A. C. H. Mental Health, Llc 5 Shawan Rd Ste 101c Hunt Valley MD 21030-1373 Ph: (443) 982-0692 |
| NPI Number | 1265771646 |
|---|---|
| Provider Enumeration Date | 02/05/2013 |
| Last Update Date | 02/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265771646 | NPI | - | NPPES |
| BH001372 | Other | MD | MARYLAND DEPARTMENT OF HEALTH, BEHAVIORAL HEALTH ADMINISTRATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LC3757 (Maryland) | Primary |
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