| Harwood Behavioral Health Ii Llc | |
|
428 E 25th St Baltimore MD 21218-5304 | |
| (240) 813-9867 | |
| Not Available |
| Full Name | Harwood Behavioral Health Ii Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 428 E 25th St, Baltimore, Maryland |
| Authorized Official Name and Position | Keonna Armstrong (VP OF REVENUE CYCLE MANAGEMENT) |
| Authorized Official Contact | 2408139867 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harwood Behavioral Health Ii Llc 428 E 25th St Baltimore MD 21218-5304 Ph: (240) 813-9867 | Harwood Behavioral Health Ii Llc 428 E 25th St Baltimore MD 21218-5304 Ph: (240) 813-9867 |
| NPI Number | 1225544810 |
|---|---|
| Provider Enumeration Date | 12/19/2017 |
| Last Update Date | 08/21/2024 |
| Certification Date | 08/21/2024 |
| Medicare PECOS PAC ID | 8527378397 |
|---|---|
| Medicare Enrollment ID | O20151106000246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225544810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Daphne Ruth Bolden |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1073861886 PECOS PAC ID: 0446550040 Enrollment ID: I20151204000052 |
| Provider Name | Juyeon Shin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093171696 PECOS PAC ID: 2466742408 Enrollment ID: I20160603001725 |
| Provider Name | Lynn S Feldman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609979764 PECOS PAC ID: 8022109297 Enrollment ID: I20160816001143 |
| Provider Name | Ruth Ogbans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407487101 PECOS PAC ID: 1557790706 Enrollment ID: I20200409000421 |
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