| Upstream Journeys Llc | |
|
4690 Millennium Dr Ste 300 Belcamp MD 21017-1527 | |
| (410) 888-7740 | |
| Not Available |
| Full Name | Upstream Journeys Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 4690 Millennium Dr Ste 300, Belcamp, Maryland |
| Authorized Official Name and Position | Jendayi Gantt (PRACTICE OWNER) |
| Authorized Official Contact | 4108887740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstream Journeys Llc 4690 Millennium Dr Ste 300 Belcamp MD 21017-1527 Ph: (410) 888-7740 | Upstream Journeys Llc 4690 Millennium Dr Ste 300 Belcamp MD 21017-1527 Ph: (410) 888-7740 |
| NPI Number | 1295565190 |
|---|---|
| Provider Enumeration Date | 08/05/2024 |
| Last Update Date | 08/05/2024 |
| Certification Date | 08/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295565190 | NPI | - | NPPES |
| 1235386939 | Other | MD | PSYCHIATRIC NURSE PRACTITIONER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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