Provider Demographics
NPI:1083033708
Name:KRAUS BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:KRAUS BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-421-0204
Mailing Address - Street 1:114 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-1937
Mailing Address - Country:US
Mailing Address - Phone:443-421-0204
Mailing Address - Fax:443-267-0192
Practice Address - Street 1:114 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-1937
Practice Address - Country:US
Practice Address - Phone:443-421-0204
Practice Address - Fax:443-267-0192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR080023363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty