Provider Demographics
NPI:1548754575
Name:M&M BEHAVIORAL HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:M&M BEHAVIORAL HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-766-6624
Mailing Address - Street 1:1406 CRAIN HWY S STE 104
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4086
Mailing Address - Country:US
Mailing Address - Phone:410-766-6624
Mailing Address - Fax:410-766-0240
Practice Address - Street 1:1406 CRAIN HWY S STE 102, 104, 106
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4086
Practice Address - Country:US
Practice Address - Phone:410-766-6624
Practice Address - Fax:410-766-0240
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:M&M BEHAVIORAL HEALTH SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-22
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDBH000807261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBH000807Medicaid