Provider Demographics
| NPI: | 1174358584 |
|---|---|
| Name: | AMAZING CARE MENTAL HEALTH & SUD SERVICES, LLC |
| Entity type: | Organization |
| Organization Name: | AMAZING CARE MENTAL HEALTH & SUD SERVICES, LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DR. OWNER/ CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | STELLA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | EPEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 410-265-0023 |
| Mailing Address - Street 1: | 4813 SETON DR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BALTIMORE |
| Mailing Address - State: | MD |
| Mailing Address - Zip Code: | 21215-3211 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 410-937-7897 |
| Mailing Address - Fax: | 410-265-0027 |
| Practice Address - Street 1: | 4813 SETON DR |
| Practice Address - Street 2: | |
| Practice Address - City: | BALTIMORE |
| Practice Address - State: | MD |
| Practice Address - Zip Code: | 21215-3211 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 410-937-7897 |
| Practice Address - Fax: | 410-265-0027 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2024-09-05 |
| Last Update Date: | 2024-09-05 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | |
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
| No | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
| No | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
