Provider Demographics
NPI:1326295098
Name:AXIS HEALTHCARE GROUP
Entity Type:Organization
Organization Name:AXIS HEALTHCARE GROUP
Other - Org Name:CAREMIND HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-360-4787
Mailing Address - Street 1:8040 GEORGIA AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4959
Mailing Address - Country:US
Mailing Address - Phone:301-363-2575
Mailing Address - Fax:202-360-4787
Practice Address - Street 1:8040 GEORGIA AVE STE 170
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4959
Practice Address - Country:US
Practice Address - Phone:202-360-4787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD341022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC060330600Medicaid
MD417016400Medicaid
MD419309100Medicaid
DC134100Medicare PIN
DC060330600Medicaid