Provider Demographics
NPI:1043096555
Name:DESTINED 4 GREATNESS BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:DESTINED 4 GREATNESS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:SATTERFIELD
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMSW, LCADC
Authorized Official - Phone:443-454-5972
Mailing Address - Street 1:10048 PADUA WAY
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4065
Mailing Address - Country:US
Mailing Address - Phone:443-454-5972
Mailing Address - Fax:
Practice Address - Street 1:9401 WHITE CEDAR DR
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-7516
Practice Address - Country:US
Practice Address - Phone:443-454-5972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit