Provider Demographics
NPI:1508595091
Name:TEAM K BEHAVIORAL HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:TEAM K BEHAVIORAL HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FALAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUROUMA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:443-839-7448
Mailing Address - Street 1:1100 BOLTON ST SPC 1500
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-2222
Mailing Address - Country:US
Mailing Address - Phone:443-839-7448
Mailing Address - Fax:443-438-7850
Practice Address - Street 1:1100 BOLTON ST SPC 1500
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-2222
Practice Address - Country:US
Practice Address - Phone:443-839-7448
Practice Address - Fax:443-438-7850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health