| C. O. A. C. H. Mental Health, Llc | |
|
1220a E Joppa Rd Ste 230b Towson MD 21286-5822 | |
| (443) 982-0692 | |
| (410) 616-9294 |
| Full Name | C. O. A. C. H. Mental Health, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1220a E Joppa Rd Ste 230b, Towson, Maryland |
| Authorized Official Name and Position | Dwayne T Green (OWNER/THERAPIST) |
| Authorized Official Contact | 4439820692 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C. O. A. C. H. Mental Health, Llc 1220a E Joppa Rd Ste 230b Towson MD 21286-5822 Ph: (443) 982-0692 | C. O. A. C. H. Mental Health, Llc 1220a E Joppa Rd Ste 230b Towson MD 21286-5822 Ph: (443) 982-0692 |
| NPI Number | 1912464835 |
|---|---|
| Provider Enumeration Date | 02/27/2019 |
| Last Update Date | 09/22/2023 |
| Certification Date | 09/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912464835 | NPI | - | NPPES |
| BH001372 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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