Provider Demographics
NPI:1538697495
Name:NATIONAL PIKE HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:NATIONAL PIKE HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-812-4863
Mailing Address - Street 1:1201 W PRATT ST STE D
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-2674
Mailing Address - Country:US
Mailing Address - Phone:410-744-8100
Mailing Address - Fax:410-744-2530
Practice Address - Street 1:1201 W PRATT ST STE D
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-2674
Practice Address - Country:US
Practice Address - Phone:410-744-8100
Practice Address - Fax:410-744-2530
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL PIKE HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMH2318101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty