Provider Demographics
NPI:1073087136
Name:BEAUTIFUL HEARTS AND MINDS HEALTH SERVICES
Entity Type:Organization
Organization Name:BEAUTIFUL HEARTS AND MINDS HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAKESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-813-9961
Mailing Address - Street 1:1404 W BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-2403
Mailing Address - Country:US
Mailing Address - Phone:410-800-2121
Mailing Address - Fax:443-478-4716
Practice Address - Street 1:1404 W BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-2403
Practice Address - Country:US
Practice Address - Phone:410-800-2121
Practice Address - Fax:443-478-4716
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEAUTIFUL HEARTS AND MINDS HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-11
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty