| E&b Behavioral And Medical Clinic Llc | |
|
15305 Beaufort Pl Silver Spring MD 20905-4203 | |
| (513) 295-9807 | |
| Not Available |
| Full Name | E&b Behavioral And Medical Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15305 Beaufort Pl, Silver Spring, Maryland |
| Authorized Official Name and Position | Ernest Keyaka (PROVIDER) |
| Authorized Official Contact | 5132959807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| E&b Behavioral And Medical Clinic Llc 15305 Beaufort Pl Silver Spring MD 20905-4203 Ph: (513) 295-9807 | E&b Behavioral And Medical Clinic Llc 15305 Beaufort Pl Silver Spring MD 20905-4203 Ph: (513) 295-9807 |
| NPI Number | 1588382774 |
|---|---|
| Provider Enumeration Date | 08/15/2022 |
| Last Update Date | 08/15/2022 |
| Certification Date | 08/15/2022 |
| Medicare PECOS PAC ID | 1951775857 |
|---|---|
| Medicare Enrollment ID | O20230315003154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588382774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ernest Keyaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518504307 PECOS PAC ID: 2961873898 Enrollment ID: I20230131003508 |
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