| Greater Baltimore Behavioral Health Services Llc | |
|
402 E 25th St Fl 1 Baltimore MD 21218-5304 | |
| (410) 889-3000 | |
| (410) 889-3003 |
| Full Name | Greater Baltimore Behavioral Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 402 E 25th St Fl 1, Baltimore, Maryland |
| Authorized Official Name and Position | Olanrewaju Etti (PROGRAM DIRECTOR) |
| Authorized Official Contact | 4436004067 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Baltimore Behavioral Health Services Llc 402 E 25th St Fl 1 Baltimore MD 21218-5304 Ph: (410) 889-3000 | Greater Baltimore Behavioral Health Services Llc 402 E 25th St Fl 1 Baltimore MD 21218-5304 Ph: (410) 889-3000 |
| NPI Number | 1538796735 |
|---|---|
| Provider Enumeration Date | 03/26/2020 |
| Last Update Date | 03/26/2020 |
| Certification Date | 03/26/2020 |
| Medicare PECOS PAC ID | 3870989783 |
|---|---|
| Medicare Enrollment ID | O20220401000571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538796735 | NPI | - | NPPES |
| 4108893000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Eric Angeme Amene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750641221 PECOS PAC ID: 9830424209 Enrollment ID: I20190709000609 |
| Provider Name | Esther Chikwe-onyejekwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265084644 PECOS PAC ID: 7416386883 Enrollment ID: I20200406002466 |
| Provider Name | Virginia W Kamau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720662711 PECOS PAC ID: 8729471578 Enrollment ID: I20220131001974 |
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